|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
IP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$284.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.77
|
| Rate for Payer: Multiplan Commercial |
$385.91
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
OP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$410.03 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$291.99
|
| Rate for Payer: Blue Shield of California Commercial |
$244.57
|
| Rate for Payer: Blue Shield of California Commercial |
$370.96
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$284.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$337.67
|
| Rate for Payer: Multiplan Commercial |
$385.91
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.03
|
| Rate for Payer: Vantage Medical Group Senior |
$410.03
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$184.87 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.56
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Cigna of CA HMO |
$139.19
|
| Rate for Payer: Cigna of CA PPO |
$160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.24
|
| Rate for Payer: Multiplan Commercial |
$173.99
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.75
|
| Rate for Payer: United Healthcare All Other HMO |
$108.75
|
| Rate for Payer: United Healthcare HMO Rider |
$108.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.87
|
| Rate for Payer: Vantage Medical Group Senior |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.62
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$184.87 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$173.99
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
OP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$204.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$278.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$238.65
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Cigna of CA HMO |
$238.02
|
| Rate for Payer: Cigna of CA PPO |
$275.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$316.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$316.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$316.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$260.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$219.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$260.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$260.33
|
| Rate for Payer: Multiplan Commercial |
$297.52
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$185.95
|
| Rate for Payer: United Healthcare All Other HMO |
$185.95
|
| Rate for Payer: United Healthcare HMO Rider |
$185.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$316.12
|
| Rate for Payer: Vantage Medical Group Senior |
$316.12
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
IP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$316.12 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$260.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$219.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.26
|
| Rate for Payer: Multiplan Commercial |
$297.52
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
IP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$566.48 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.95
|
| Rate for Payer: Multiplan Commercial |
$533.16
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
OP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$566.48 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$366.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$499.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$427.66
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Cigna of CA HMO |
$426.53
|
| Rate for Payer: Cigna of CA PPO |
$493.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$566.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$566.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$241.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.51
|
| Rate for Payer: Multiplan Commercial |
$533.16
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.23
|
| Rate for Payer: United Healthcare All Other HMO |
$333.23
|
| Rate for Payer: United Healthcare HMO Rider |
$333.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$333.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.48
|
| Rate for Payer: Vantage Medical Group Senior |
$566.48
|
|
|
HC CATH RESCUE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| 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 Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH RESCUE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| 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 |
$372.19
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
IP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$317.99 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.78
|
| Rate for Payer: Multiplan Commercial |
$299.28
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
OP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$317.99 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$245.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.06
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Cigna of CA HMO |
$239.42
|
| Rate for Payer: Cigna of CA PPO |
$276.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.87
|
| Rate for Payer: Multiplan Commercial |
$299.28
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$187.05
|
| Rate for Payer: United Healthcare All Other HMO |
$187.05
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$187.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.99
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
OP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$41.61 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.41
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cigna of CA HMO |
$31.33
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.27
|
| Rate for Payer: Multiplan Commercial |
$39.16
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.48
|
| Rate for Payer: United Healthcare All Other HMO |
$24.48
|
| Rate for Payer: United Healthcare HMO Rider |
$24.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.61
|
| Rate for Payer: Vantage Medical Group Senior |
$41.61
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
IP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$41.61 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$39.16
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
IP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$3.74
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
OP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.00
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$2.99
|
| Rate for Payer: Cigna of CA PPO |
$3.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$3.74
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2.33
|
| Rate for Payer: United Healthcare HMO Rider |
$2.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.97
|
| Rate for Payer: Vantage Medical Group Senior |
$3.97
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
IP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$512.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
OP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$570.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$652.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$557.89
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$556.42
|
| Rate for Payer: Cigna of CA PPO |
$643.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$738.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$315.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$512.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.58
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
OP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.73
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Cigna of CA HMO |
$7.71
|
| Rate for Payer: Cigna of CA PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO |
$6.03
|
| Rate for Payer: United Healthcare HMO Rider |
$6.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.24
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
IP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
OP
|
$35.67
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$30.32 |
| Rate for Payer: Adventist Health Commercial |
$7.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.89
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cigna of CA HMO |
$22.83
|
| Rate for Payer: Cigna of CA PPO |
$26.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$14.27
|
| Rate for Payer: Galaxy Health WC |
$30.32
|
| Rate for Payer: Global Benefits Group Commercial |
$21.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.97
|
| Rate for Payer: Multiplan Commercial |
$28.54
|
| Rate for Payer: Networks By Design Commercial |
$23.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.84
|
| Rate for Payer: United Healthcare All Other HMO |
$17.84
|
| Rate for Payer: United Healthcare HMO Rider |
$17.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.32
|
| Rate for Payer: Vantage Medical Group Senior |
$30.32
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
IP
|
$35.67
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$30.32 |
| Rate for Payer: Adventist Health Commercial |
$7.13
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$14.27
|
| Rate for Payer: Galaxy Health WC |
$30.32
|
| Rate for Payer: Global Benefits Group Commercial |
$21.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.56
|
| Rate for Payer: Multiplan Commercial |
$28.54
|
| Rate for Payer: Networks By Design Commercial |
$23.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.32
|
|
|
HC CATH SELF-CATH 14FR LONG
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
901603666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Adventist Health Commercial |
$1.05
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Senior |
$2.10
|
| Rate for Payer: Galaxy Health WC |
$4.46
|
| Rate for Payer: Global Benefits Group Commercial |
$3.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$3.41
|
| Rate for Payer: Prime Health Services Commercial |
$4.46
|
|
