|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
IP
|
$58.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$11.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cigna of CA HMO |
$40.75
|
| Rate for Payer: Cigna of CA PPO |
$40.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Senior |
$23.29
|
| Rate for Payer: Galaxy Health WC |
$49.49
|
| Rate for Payer: Global Benefits Group Commercial |
$34.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.97
|
| Rate for Payer: Multiplan Commercial |
$46.58
|
| Rate for Payer: Networks By Design Commercial |
$29.11
|
| Rate for Payer: Prime Health Services Commercial |
$49.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.85
|
| Rate for Payer: United Healthcare All Other HMO |
$21.27
|
| Rate for Payer: United Healthcare HMO Rider |
$20.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.07
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
OP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$47.88 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.10
|
| Rate for Payer: Blue Shield of California Commercial |
$28.56
|
| Rate for Payer: Blue Shield of California Commercial |
$43.32
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.43
|
| Rate for Payer: Multiplan Commercial |
$45.06
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.88
|
| Rate for Payer: Vantage Medical Group Senior |
$47.88
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
IP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.52
|
| Rate for Payer: Multiplan Commercial |
$45.06
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
IP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: Multiplan Commercial |
$47.36
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
OP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$50.32 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.83
|
| Rate for Payer: Blue Shield of California Commercial |
$30.01
|
| Rate for Payer: Blue Shield of California Commercial |
$45.52
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.44
|
| Rate for Payer: Multiplan Commercial |
$47.36
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.32
|
| Rate for Payer: Vantage Medical Group Senior |
$50.32
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
OP
|
$1,209.39
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$1,027.98 |
| Rate for Payer: Adventist Health Commercial |
$241.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$665.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$732.04
|
| Rate for Payer: Blue Shield of California Commercial |
$613.16
|
| Rate for Payer: Blue Shield of California Commercial |
$930.02
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cigna of CA HMO |
$846.57
|
| Rate for Payer: Cigna of CA PPO |
$846.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,027.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,027.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$846.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.76
|
| Rate for Payer: EPIC Health Plan Senior |
$483.76
|
| Rate for Payer: Galaxy Health WC |
$1,027.98
|
| Rate for Payer: Global Benefits Group Commercial |
$725.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$767.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$713.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$846.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$846.57
|
| Rate for Payer: Multiplan Commercial |
$967.51
|
| Rate for Payer: Networks By Design Commercial |
$604.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$725.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$453.88
|
| Rate for Payer: United Healthcare All Other HMO |
$441.79
|
| Rate for Payer: United Healthcare HMO Rider |
$432.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,027.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,027.98
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
IP
|
$1,209.39
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$241.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cigna of CA HMO |
$846.57
|
| Rate for Payer: Cigna of CA PPO |
$846.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$846.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.76
|
| Rate for Payer: EPIC Health Plan Senior |
$483.76
|
| Rate for Payer: Galaxy Health WC |
$1,027.98
|
| Rate for Payer: Global Benefits Group Commercial |
$725.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$767.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$713.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.25
|
| Rate for Payer: Multiplan Commercial |
$967.51
|
| Rate for Payer: Networks By Design Commercial |
$604.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$453.88
|
| Rate for Payer: United Healthcare All Other HMO |
$441.79
|
| Rate for Payer: United Healthcare HMO Rider |
$432.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.08
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
IP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$539.58 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$444.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$374.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.35
|
| Rate for Payer: Multiplan Commercial |
$507.84
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
OP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$539.58 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$407.35
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$539.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$444.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$230.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$374.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$444.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$444.36
|
| Rate for Payer: Multiplan Commercial |
$507.84
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$450.34
|
| Rate for Payer: Blue Shield of California Commercial |
$377.21
|
| Rate for Payer: Blue Shield of California Commercial |
$572.14
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$632.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$270.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$520.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.40
|
| Rate for Payer: Vantage Medical Group Senior |
$632.40
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,360.67
|
| Rate for Payer: Blue Shield of California Commercial |
$1,977.30
|
| Rate for Payer: Blue Shield of California Commercial |
$2,999.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
IP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$143.63 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$118.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.56
|
| Rate for Payer: Multiplan Commercial |
$135.18
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
OP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$143.63 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$92.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$126.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.43
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Cigna of CA HMO |
$108.15
|
| Rate for Payer: Cigna of CA PPO |
$125.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$143.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$143.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$118.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$118.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$118.29
|
| Rate for Payer: Multiplan Commercial |
$135.18
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.49
|
| Rate for Payer: United Healthcare All Other HMO |
$84.49
|
| Rate for Payer: United Healthcare HMO Rider |
$84.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.63
|
| Rate for Payer: Vantage Medical Group Senior |
$143.63
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
OP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$731.17 |
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$564.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$645.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$551.99
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Cigna of CA HMO |
$550.53
|
| Rate for Payer: Cigna of CA PPO |
$636.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$731.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$602.14
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$546.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$312.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$507.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.14
|
| Rate for Payer: Multiplan Commercial |
$688.16
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$430.10
|
| Rate for Payer: United Healthcare All Other HMO |
$430.10
|
| Rate for Payer: United Healthcare HMO Rider |
$430.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$430.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Vantage Medical Group Senior |
$731.17
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
IP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$731.17 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$602.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$546.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$507.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.45
|
| Rate for Payer: Multiplan Commercial |
$688.16
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
IP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Cash Price |
$356.04
|
| 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 |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
OP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$518.95
|
| 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 |
$507.71
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$506.37
|
| Rate for Payer: Cigna of CA PPO |
$585.49
|
| 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 |
$514.28
|
| 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 |
$395.60
|
| Rate for Payer: United Healthcare All Other HMO |
$395.60
|
| Rate for Payer: United Healthcare HMO Rider |
$395.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.60
|
| 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 TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| 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: 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 |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| 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
|
|
|
HC CATH TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
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
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
OP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$116.86 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.22
|
| Rate for Payer: Blue Shield of California Commercial |
$105.72
|
| Rate for Payer: Blue Shield of California Commercial |
$69.70
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.24
|
| Rate for Payer: Multiplan Commercial |
$109.98
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.86
|
| Rate for Payer: Vantage Medical Group Senior |
$116.86
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
IP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$109.98
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
IP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.46
|
| Rate for Payer: Multiplan Commercial |
$104.88
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
OP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$111.44 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.35
|
| Rate for Payer: Blue Shield of California Commercial |
$100.82
|
| Rate for Payer: Blue Shield of California Commercial |
$66.47
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.77
|
| Rate for Payer: Multiplan Commercial |
$104.88
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.44
|
| Rate for Payer: Vantage Medical Group Senior |
$111.44
|
|
