|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
OP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$657.42 |
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$468.16
|
| Rate for Payer: Blue Shield of California Commercial |
$392.13
|
| Rate for Payer: Blue Shield of California Commercial |
$594.78
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.41
|
| Rate for Payer: Multiplan Commercial |
$618.75
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.42
|
| Rate for Payer: Vantage Medical Group Senior |
$657.42
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
IP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.63
|
| Rate for Payer: Multiplan Commercial |
$618.75
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
OP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.91
|
| Rate for Payer: Blue Shield of California Commercial |
$401.14
|
| Rate for Payer: Blue Shield of California Commercial |
$608.43
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$287.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$553.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
IP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
IP
|
$831.82
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.36 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$166.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cigna of CA HMO |
$582.27
|
| Rate for Payer: Cigna of CA PPO |
$582.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$582.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.73
|
| Rate for Payer: EPIC Health Plan Senior |
$332.73
|
| Rate for Payer: Galaxy Health WC |
$707.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$528.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Multiplan Commercial |
$665.46
|
| Rate for Payer: Networks By Design Commercial |
$415.91
|
| Rate for Payer: Prime Health Services Commercial |
$707.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$312.18
|
| Rate for Payer: United Healthcare All Other HMO |
$303.86
|
| Rate for Payer: United Healthcare HMO Rider |
$297.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.42
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
OP
|
$831.82
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.36 |
| Max. Negotiated Rate |
$707.05 |
| Rate for Payer: Adventist Health Commercial |
$166.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$707.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$457.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$623.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$503.50
|
| Rate for Payer: Blue Shield of California Commercial |
$421.73
|
| Rate for Payer: Blue Shield of California Commercial |
$639.67
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cigna of CA HMO |
$582.27
|
| Rate for Payer: Cigna of CA PPO |
$582.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$707.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$707.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$707.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$582.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.73
|
| Rate for Payer: EPIC Health Plan Senior |
$332.73
|
| Rate for Payer: Galaxy Health WC |
$707.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$528.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$301.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$582.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$582.27
|
| Rate for Payer: Multiplan Commercial |
$665.46
|
| Rate for Payer: Networks By Design Commercial |
$415.91
|
| Rate for Payer: Prime Health Services Commercial |
$707.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$499.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$499.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$312.18
|
| Rate for Payer: United Healthcare All Other HMO |
$303.86
|
| Rate for Payer: United Healthcare HMO Rider |
$297.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$707.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$707.05
|
| Rate for Payer: Vantage Medical Group Senior |
$707.05
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
OP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$756.70 |
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$489.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$667.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$538.86
|
| Rate for Payer: Blue Shield of California Commercial |
$451.35
|
| Rate for Payer: Blue Shield of California Commercial |
$684.59
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$756.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$756.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$623.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$565.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$323.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$525.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.17
|
| Rate for Payer: Multiplan Commercial |
$712.19
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$534.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.70
|
| Rate for Payer: Vantage Medical Group Senior |
$756.70
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
IP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$623.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$565.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$525.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.66
|
| Rate for Payer: Multiplan Commercial |
$712.19
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
OP
|
$910.62
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$774.03 |
| Rate for Payer: Adventist Health Commercial |
$182.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$774.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$500.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$682.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$551.20
|
| Rate for Payer: Blue Shield of California Commercial |
$461.68
|
| Rate for Payer: Blue Shield of California Commercial |
$700.27
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cigna of CA HMO |
$637.43
|
| Rate for Payer: Cigna of CA PPO |
$637.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$774.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$774.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$774.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$637.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$364.25
|
| Rate for Payer: EPIC Health Plan Senior |
$364.25
|
| Rate for Payer: Galaxy Health WC |
$774.03
|
| Rate for Payer: Global Benefits Group Commercial |
$546.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$578.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$537.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$637.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$637.43
|
| Rate for Payer: Multiplan Commercial |
$728.50
|
| Rate for Payer: Networks By Design Commercial |
$455.31
|
| Rate for Payer: Prime Health Services Commercial |
$774.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$546.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$546.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.76
|
| Rate for Payer: United Healthcare All Other HMO |
$332.65
|
| Rate for Payer: United Healthcare HMO Rider |
$325.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$298.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$774.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$774.03
|
| Rate for Payer: Vantage Medical Group Senior |
$774.03
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
IP
|
$910.62
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$182.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cigna of CA HMO |
$637.43
|
| Rate for Payer: Cigna of CA PPO |
$637.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$637.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$364.25
|
| Rate for Payer: EPIC Health Plan Senior |
$364.25
|
| Rate for Payer: Galaxy Health WC |
$774.03
|
| Rate for Payer: Global Benefits Group Commercial |
$546.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$578.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$537.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.55
|
| Rate for Payer: Multiplan Commercial |
$728.50
|
| Rate for Payer: Networks By Design Commercial |
$455.31
|
| Rate for Payer: Prime Health Services Commercial |
$774.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.76
|
| Rate for Payer: United Healthcare All Other HMO |
$332.65
|
| Rate for Payer: United Healthcare HMO Rider |
$325.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$298.23
|
|
|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,475.91
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
OP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$990.16 |
| Rate for Payer: Adventist Health Commercial |
$232.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$764.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$990.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$640.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$873.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.52
|
| Rate for Payer: Cash Price |
$524.21
|
| Rate for Payer: Cigna of CA HMO |
$745.54
|
| Rate for Payer: Cigna of CA PPO |
$862.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$990.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$990.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$990.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$815.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: EPIC Health Plan Senior |
$465.96
|
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$739.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$422.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$687.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.43
|
| Rate for Payer: Multiplan Commercial |
$931.92
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$698.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$698.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$582.45
|
| Rate for Payer: United Healthcare All Other HMO |
$582.45
|
| Rate for Payer: United Healthcare HMO Rider |
$582.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$582.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$990.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$990.16
|
| Rate for Payer: Vantage Medical Group Senior |
$990.16
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
IP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$990.16 |
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Adventist Health Commercial |
$232.98
|
| Rate for Payer: Cash Price |
$524.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$815.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: EPIC Health Plan Senior |
$465.96
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$739.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$687.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.58
|
| Rate for Payer: Multiplan Commercial |
$931.92
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
OP
|
$45.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Multiplan Commercial |
$36.41
|
| Rate for Payer: Networks By Design Commercial |
$29.58
|
| Rate for Payer: Adventist Health Commercial |
$9.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.20
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cigna of CA HMO |
$29.13
|
| Rate for Payer: Cigna of CA PPO |
$33.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$31.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Senior |
$18.20
|
| Rate for Payer: Galaxy Health WC |
$38.68
|
| Rate for Payer: Global Benefits Group Commercial |
$27.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$26.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.86
|
| Rate for Payer: Prime Health Services Commercial |
$38.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.75
|
| Rate for Payer: United Healthcare All Other HMO |
$22.75
|
| Rate for Payer: United Healthcare HMO Rider |
$22.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.68
|
| Rate for Payer: Vantage Medical Group Senior |
$38.68
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
IP
|
$45.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$38.68 |
| Rate for Payer: Adventist Health Commercial |
$9.10
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$31.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Senior |
$18.20
|
| Rate for Payer: Galaxy Health WC |
$38.68
|
| Rate for Payer: Global Benefits Group Commercial |
$27.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$26.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.92
|
| Rate for Payer: Multiplan Commercial |
$36.41
|
| Rate for Payer: Networks By Design Commercial |
$29.58
|
| Rate for Payer: Prime Health Services Commercial |
$38.68
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
IP
|
$49.28
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$41.89 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
OP
|
$49.28
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.62
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cigna of CA HMO |
$31.54
|
| Rate for Payer: Cigna of CA PPO |
$36.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.64
|
| Rate for Payer: United Healthcare All Other HMO |
$24.64
|
| Rate for Payer: United Healthcare HMO Rider |
$24.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.89
|
| Rate for Payer: Vantage Medical Group Senior |
$41.89
|
|
|
HC CATH PEDS FOLEY TRAY 10FR 5ML
|
Facility
|
OP
|
$226.45
|
|
| Hospital Charge Code |
901698909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$192.48 |
| Rate for Payer: Adventist Health Commercial |
$45.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$192.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.31
|
| Rate for Payer: Cash Price |
$101.90
|
| Rate for Payer: Cigna of CA HMO |
$144.93
|
| Rate for Payer: Cigna of CA PPO |
$167.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$192.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$192.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$192.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$158.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.58
|
| Rate for Payer: EPIC Health Plan Senior |
$90.58
|
| Rate for Payer: Galaxy Health WC |
$192.48
|
| Rate for Payer: Global Benefits Group Commercial |
$135.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$143.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$133.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$158.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$158.51
|
| Rate for Payer: Multiplan Commercial |
$181.16
|
| Rate for Payer: Networks By Design Commercial |
$147.19
|
| Rate for Payer: Prime Health Services Commercial |
$192.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.22
|
| Rate for Payer: United Healthcare All Other HMO |
$113.22
|
| Rate for Payer: United Healthcare HMO Rider |
$113.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$192.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$192.48
|
| Rate for Payer: Vantage Medical Group Senior |
$192.48
|
|
|
HC CATH PEDS FOLEY TRAY 10FR 5ML
|
Facility
|
IP
|
$226.45
|
|
| Hospital Charge Code |
901698909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$192.48 |
| Rate for Payer: Adventist Health Commercial |
$45.29
|
| Rate for Payer: Cash Price |
$101.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$158.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.58
|
| Rate for Payer: EPIC Health Plan Senior |
$90.58
|
| Rate for Payer: Galaxy Health WC |
$192.48
|
| Rate for Payer: Global Benefits Group Commercial |
$135.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$143.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$133.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.35
|
| Rate for Payer: Multiplan Commercial |
$181.16
|
| Rate for Payer: Networks By Design Commercial |
$147.19
|
| Rate for Payer: Prime Health Services Commercial |
$192.48
|
|
|
HC CATH PEDS FOLEY TRAY 8FR 3ML
|
Facility
|
IP
|
$202.86
|
|
| Hospital Charge Code |
901698910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$172.43 |
| Rate for Payer: Adventist Health Commercial |
$40.57
|
| Rate for Payer: Cash Price |
$91.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$142.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.14
|
| Rate for Payer: EPIC Health Plan Senior |
$81.14
|
| Rate for Payer: Galaxy Health WC |
$172.43
|
| Rate for Payer: Global Benefits Group Commercial |
$121.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$128.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$119.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.69
|
| Rate for Payer: Multiplan Commercial |
$162.29
|
| Rate for Payer: Networks By Design Commercial |
$131.86
|
| Rate for Payer: Prime Health Services Commercial |
$172.43
|
|
|
HC CATH PEDS FOLEY TRAY 8FR 3ML
|
Facility
|
OP
|
$202.86
|
|
| Hospital Charge Code |
901698910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$172.43 |
| Rate for Payer: Adventist Health Commercial |
$40.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$172.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$111.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.18
|
| Rate for Payer: Cash Price |
$91.29
|
| Rate for Payer: Cigna of CA HMO |
$129.83
|
| Rate for Payer: Cigna of CA PPO |
$150.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$172.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$172.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$172.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$142.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.14
|
| Rate for Payer: EPIC Health Plan Senior |
$81.14
|
| Rate for Payer: Galaxy Health WC |
$172.43
|
| Rate for Payer: Global Benefits Group Commercial |
$121.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$128.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$73.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$119.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.00
|
| Rate for Payer: Multiplan Commercial |
$162.29
|
| Rate for Payer: Networks By Design Commercial |
$131.86
|
| Rate for Payer: Prime Health Services Commercial |
$172.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.43
|
| Rate for Payer: United Healthcare All Other HMO |
$101.43
|
| Rate for Payer: United Healthcare HMO Rider |
$101.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$172.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$172.43
|
| Rate for Payer: Vantage Medical Group Senior |
$172.43
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
IP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$14,582.60 |
| Rate for Payer: Adventist Health Commercial |
$3,431.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,009.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,894.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,122.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.44
|
| Rate for Payer: Multiplan Commercial |
$13,724.80
|
| Rate for Payer: Networks By Design Commercial |
$8,578.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,438.65
|
| Rate for Payer: United Healthcare All Other HMO |
$6,267.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6,131.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,618.59
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
OP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$14,582.60 |
| Rate for Payer: Adventist Health Commercial |
$3,431.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,435.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,867.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,384.53
|
| Rate for Payer: Blue Shield of California Commercial |
$13,192.96
|
| Rate for Payer: Blue Shield of California Commercial |
$8,698.09
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,582.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,582.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,009.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,894.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,227.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,122.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,009.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,009.20
|
| Rate for Payer: Multiplan Commercial |
$13,724.80
|
| Rate for Payer: Networks By Design Commercial |
$8,578.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,293.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,293.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,438.65
|
| Rate for Payer: United Healthcare All Other HMO |
$6,267.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6,131.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,618.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,582.60
|
| Rate for Payer: Vantage Medical Group Senior |
$14,582.60
|
|
|
HC CATH PENUMBRA SELECT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$294.06
|
| Rate for Payer: Blue Shield of California Commercial |
$446.02
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
