|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
OP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$113.95 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.15
|
| Rate for Payer: Blue Shield of California Commercial |
$103.09
|
| Rate for Payer: Blue Shield of California Commercial |
$67.97
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.95
|
| Rate for Payer: Vantage Medical Group Senior |
$113.95
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
IP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.17
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.76
|
| Rate for Payer: Multiplan Commercial |
$92.54
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$86.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.02
|
| Rate for Payer: Blue Shield of California Commercial |
$58.64
|
| Rate for Payer: Blue Shield of California Commercial |
$88.95
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$98.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$98.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80.97
|
| Rate for Payer: Multiplan Commercial |
$92.54
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$98.32
|
| Rate for Payer: Vantage Medical Group Senior |
$98.32
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
IP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$82.76 |
| Rate for Payer: Adventist Health Commercial |
$19.47
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.37
|
| Rate for Payer: Multiplan Commercial |
$77.89
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
OP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$82.76 |
| Rate for Payer: Adventist Health Commercial |
$19.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.48
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Cigna of CA HMO |
$62.31
|
| Rate for Payer: Cigna of CA PPO |
$72.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.15
|
| Rate for Payer: Multiplan Commercial |
$77.89
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.68
|
| Rate for Payer: United Healthcare All Other HMO |
$48.68
|
| Rate for Payer: United Healthcare HMO Rider |
$48.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.76
|
| Rate for Payer: Vantage Medical Group Senior |
$82.76
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
IP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
OP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.21
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.77
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
IP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$90.44 |
| Rate for Payer: Adventist Health Commercial |
$21.28
|
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$74.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: EPIC Health Plan Senior |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$67.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$62.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.54
|
| Rate for Payer: Multiplan Commercial |
$85.12
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
OP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$90.44 |
| Rate for Payer: Adventist Health Commercial |
$21.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$79.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.28
|
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: Cigna of CA HMO |
$68.10
|
| Rate for Payer: Cigna of CA PPO |
$78.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$74.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: EPIC Health Plan Senior |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$67.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$62.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$74.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74.48
|
| Rate for Payer: Multiplan Commercial |
$85.12
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.20
|
| Rate for Payer: United Healthcare All Other HMO |
$53.20
|
| Rate for Payer: United Healthcare HMO Rider |
$53.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$90.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.44
|
| Rate for Payer: Vantage Medical Group Senior |
$90.44
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$137.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.76
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.00
|
| Rate for Payer: United Healthcare All Other HMO |
$105.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
IP
|
$117.88
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
OP
|
$117.88
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.64
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Cigna of CA HMO |
$75.44
|
| Rate for Payer: Cigna of CA PPO |
$87.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.52
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.94
|
| Rate for Payer: United Healthcare All Other HMO |
$58.94
|
| Rate for Payer: United Healthcare HMO Rider |
$58.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.20
|
| Rate for Payer: Vantage Medical Group Senior |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
OP
|
$117.88
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77.32
|
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.64
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Cigna of CA HMO |
$75.44
|
| Rate for Payer: Cigna of CA PPO |
$87.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.52
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.94
|
| Rate for Payer: United Healthcare All Other HMO |
$58.94
|
| Rate for Payer: United Healthcare HMO Rider |
$58.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.20
|
| Rate for Payer: Vantage Medical Group Senior |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
IP
|
$117.88
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
OP
|
$51.50
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$43.77 |
| Rate for Payer: Adventist Health Commercial |
$10.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.05
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cigna of CA HMO |
$32.96
|
| Rate for Payer: Cigna of CA PPO |
$38.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20.60
|
| Rate for Payer: Galaxy Health WC |
$43.77
|
| Rate for Payer: Global Benefits Group Commercial |
$30.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.05
|
| Rate for Payer: Multiplan Commercial |
$41.20
|
| Rate for Payer: Networks By Design Commercial |
$33.48
|
| Rate for Payer: Prime Health Services Commercial |
$43.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.75
|
| Rate for Payer: United Healthcare All Other HMO |
$25.75
|
| Rate for Payer: United Healthcare HMO Rider |
$25.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.77
|
| Rate for Payer: Vantage Medical Group Senior |
$43.77
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
IP
|
$51.50
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$43.77 |
| Rate for Payer: Adventist Health Commercial |
$10.30
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20.60
|
| Rate for Payer: Galaxy Health WC |
$43.77
|
| Rate for Payer: Global Benefits Group Commercial |
$30.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.36
|
| Rate for Payer: Multiplan Commercial |
$41.20
|
| Rate for Payer: Networks By Design Commercial |
$33.48
|
| Rate for Payer: Prime Health Services Commercial |
$43.77
|
|
|
HC CATH UMBILICAL POLY DUAL 3.5FR
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
901698904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$199.32 |
| Rate for Payer: Adventist Health Commercial |
$46.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$199.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.48
|
| Rate for Payer: Cash Price |
$105.52
|
| Rate for Payer: Cigna of CA HMO |
$150.08
|
| Rate for Payer: Cigna of CA PPO |
$173.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$199.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.80
|
| Rate for Payer: EPIC Health Plan Senior |
$93.80
|
| Rate for Payer: Galaxy Health WC |
$199.32
|
| Rate for Payer: Global Benefits Group Commercial |
$140.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$148.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$85.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$164.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$164.15
|
| Rate for Payer: Multiplan Commercial |
$187.60
|
| Rate for Payer: Networks By Design Commercial |
$152.43
|
| Rate for Payer: Prime Health Services Commercial |
$199.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$140.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$140.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.25
|
| Rate for Payer: United Healthcare All Other HMO |
$117.25
|
| Rate for Payer: United Healthcare HMO Rider |
$117.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$199.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.32
|
| Rate for Payer: Vantage Medical Group Senior |
$199.32
|
|
|
HC CATH UMBILICAL POLY DUAL 3.5FR
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
901698904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$199.32 |
| Rate for Payer: Adventist Health Commercial |
$46.90
|
| Rate for Payer: Cash Price |
$105.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.80
|
| Rate for Payer: EPIC Health Plan Senior |
$93.80
|
| Rate for Payer: Galaxy Health WC |
$199.32
|
| Rate for Payer: Global Benefits Group Commercial |
$140.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$148.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.28
|
| Rate for Payer: Multiplan Commercial |
$187.60
|
| Rate for Payer: Networks By Design Commercial |
$152.43
|
| Rate for Payer: Prime Health Services Commercial |
$199.32
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
IP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.34
|
| Rate for Payer: Multiplan Commercial |
$337.79
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
OP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$358.90 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$316.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.58
|
| Rate for Payer: Blue Shield of California Commercial |
$214.08
|
| Rate for Payer: Blue Shield of California Commercial |
$324.70
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$358.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$358.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$295.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$295.57
|
| Rate for Payer: Multiplan Commercial |
$337.79
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.90
|
| Rate for Payer: Vantage Medical Group Senior |
$358.90
|
|
|
HC CATH UMBILICAL VESSEL 3.5FR
|
Facility
|
IP
|
$272.93
|
|
| Hospital Charge Code |
901698903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.59 |
| Max. Negotiated Rate |
$231.99 |
| Rate for Payer: Adventist Health Commercial |
$54.59
|
| Rate for Payer: Cash Price |
$122.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$191.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.17
|
| Rate for Payer: EPIC Health Plan Senior |
$109.17
|
| Rate for Payer: Galaxy Health WC |
$231.99
|
| Rate for Payer: Global Benefits Group Commercial |
$163.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$173.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$161.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Multiplan Commercial |
$218.34
|
| Rate for Payer: Networks By Design Commercial |
$177.40
|
| Rate for Payer: Prime Health Services Commercial |
$231.99
|
|
|
HC CATH UMBILICAL VESSEL 3.5FR
|
Facility
|
OP
|
$272.93
|
|
| Hospital Charge Code |
901698903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.59 |
| Max. Negotiated Rate |
$231.99 |
| Rate for Payer: Cigna of CA HMO |
$174.68
|
| Rate for Payer: Cigna of CA PPO |
$201.97
|
| Rate for Payer: Adventist Health Commercial |
$54.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$231.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.14
|
| Rate for Payer: Cash Price |
$122.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$231.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$231.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$231.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$191.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.17
|
| Rate for Payer: EPIC Health Plan Senior |
$109.17
|
| Rate for Payer: Galaxy Health WC |
$231.99
|
| Rate for Payer: Global Benefits Group Commercial |
$163.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$173.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$161.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.05
|
| Rate for Payer: Multiplan Commercial |
$218.34
|
| Rate for Payer: Networks By Design Commercial |
$177.40
|
| Rate for Payer: Prime Health Services Commercial |
$231.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$163.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$163.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.47
|
| Rate for Payer: United Healthcare All Other HMO |
$136.47
|
| Rate for Payer: United Healthcare HMO Rider |
$136.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$231.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$231.99
|
| Rate for Payer: Vantage Medical Group Senior |
$231.99
|
|
|
HC CATH UMBILICAL VESSEL 5.0FR
|
Facility
|
OP
|
$273.49
|
|
| Hospital Charge Code |
901603823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.70 |
| Max. Negotiated Rate |
$232.47 |
| Rate for Payer: Adventist Health Commercial |
$54.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$205.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.50
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cigna of CA HMO |
$175.03
|
| Rate for Payer: Cigna of CA PPO |
$202.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$232.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$191.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.40
|
| Rate for Payer: EPIC Health Plan Senior |
$109.40
|
| Rate for Payer: Galaxy Health WC |
$232.47
|
| Rate for Payer: Global Benefits Group Commercial |
$164.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$173.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$161.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.44
|
| Rate for Payer: Multiplan Commercial |
$218.79
|
| Rate for Payer: Networks By Design Commercial |
$177.77
|
| Rate for Payer: Prime Health Services Commercial |
$232.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.75
|
| Rate for Payer: United Healthcare All Other HMO |
$136.75
|
| Rate for Payer: United Healthcare HMO Rider |
$136.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$232.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.47
|
| Rate for Payer: Vantage Medical Group Senior |
$232.47
|
|
