|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.00
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO-FRIC HYDRO 12FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.31
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 12FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 14FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH LO-FRIC HYDRO 14FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.31
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO 12FR
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.78
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Cigna of CA HMO |
$8.76
|
| Rate for Payer: Cigna of CA PPO |
$10.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.84
|
| Rate for Payer: United Healthcare All Other HMO |
$6.84
|
| Rate for Payer: United Healthcare HMO Rider |
$6.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Vantage Medical Group Senior |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 12FR
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
IP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$75.91 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Cash Price |
$40.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.43
|
| Rate for Payer: Multiplan Commercial |
$71.44
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
OP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$75.91 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.30
|
| Rate for Payer: Cash Price |
$40.18
|
| Rate for Payer: Cigna of CA HMO |
$57.15
|
| Rate for Payer: Cigna of CA PPO |
$66.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.51
|
| Rate for Payer: Multiplan Commercial |
$71.44
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.65
|
| Rate for Payer: United Healthcare All Other HMO |
$44.65
|
| Rate for Payer: United Healthcare HMO Rider |
$44.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.91
|
| Rate for Payer: Vantage Medical Group Senior |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
OP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.79
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: Cigna of CA HMO |
$15.74
|
| Rate for Payer: Cigna of CA PPO |
$18.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.22
|
| Rate for Payer: Multiplan Commercial |
$19.68
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.30
|
| Rate for Payer: United Healthcare All Other HMO |
$12.30
|
| Rate for Payer: United Healthcare HMO Rider |
$12.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.91
|
| Rate for Payer: Vantage Medical Group Senior |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
IP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$19.68
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.00
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.31
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$11.48
|
|
| Hospital Charge Code |
901605835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$9.76 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.37
|
| Rate for Payer: Cash Price |
$5.17
|
| Rate for Payer: Cigna of CA HMO |
$7.35
|
| Rate for Payer: Cigna of CA PPO |
$8.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.59
|
| Rate for Payer: EPIC Health Plan Senior |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$9.76
|
| Rate for Payer: Global Benefits Group Commercial |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.04
|
| Rate for Payer: Multiplan Commercial |
$9.18
|
| Rate for Payer: Networks By Design Commercial |
$7.46
|
| Rate for Payer: Prime Health Services Commercial |
$9.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.74
|
| Rate for Payer: United Healthcare All Other HMO |
$5.74
|
| Rate for Payer: United Healthcare HMO Rider |
$5.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.76
|
| Rate for Payer: Vantage Medical Group Senior |
$9.76
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$11.48
|
|
| Hospital Charge Code |
901605835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$9.76 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Cash Price |
$5.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.59
|
| Rate for Payer: EPIC Health Plan Senior |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$9.76
|
| Rate for Payer: Global Benefits Group Commercial |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.76
|
| Rate for Payer: Multiplan Commercial |
$9.18
|
| Rate for Payer: Networks By Design Commercial |
$7.46
|
| Rate for Payer: Prime Health Services Commercial |
$9.76
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
