|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
IP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
OP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.63
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cigna of CA HMO |
$3.62
|
| Rate for Payer: Cigna of CA PPO |
$4.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.83
|
| Rate for Payer: United Healthcare All Other HMO |
$2.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.47
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
OP
|
$5.66
|
|
| Hospital Charge Code |
901607556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.63
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cigna of CA HMO |
$3.62
|
| Rate for Payer: Cigna of CA PPO |
$4.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.83
|
| Rate for Payer: United Healthcare All Other HMO |
$2.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.47
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
IP
|
$5.66
|
|
| Hospital Charge Code |
901607556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
|
|
HC CATH URETHRAL TRAY 14FR
|
Facility
|
IP
|
$19.35
|
|
| Hospital Charge Code |
901698668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.64
|
| Rate for Payer: Multiplan Commercial |
$15.48
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
|
|
HC CATH URETHRAL TRAY 14FR
|
Facility
|
OP
|
$19.35
|
|
| Hospital Charge Code |
901698668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.42
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Cigna of CA HMO |
$12.38
|
| Rate for Payer: Cigna of CA PPO |
$14.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.54
|
| Rate for Payer: Multiplan Commercial |
$15.48
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.68
|
| Rate for Payer: United Healthcare All Other HMO |
$9.68
|
| Rate for Payer: United Healthcare HMO Rider |
$9.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.45
|
| Rate for Payer: Vantage Medical Group Senior |
$16.45
|
|
|
HC CATH URINARY 12FRX16" ADV+
|
Facility
|
OP
|
$18.37
|
|
| Hospital Charge Code |
901602925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.79
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Cigna of CA HMO |
$11.76
|
| Rate for Payer: Cigna of CA PPO |
$13.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.86
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.19
|
| Rate for Payer: United Healthcare All Other HMO |
$9.19
|
| Rate for Payer: United Healthcare HMO Rider |
$9.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.61
|
| Rate for Payer: Vantage Medical Group Senior |
$15.61
|
|
|
HC CATH URINARY 12FRX16" ADV+
|
Facility
|
IP
|
$18.37
|
|
| Hospital Charge Code |
901602925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
|
|
HC CATH URINARY DRAIN SET 8FR
|
Facility
|
IP
|
$208.53
|
|
| Hospital Charge Code |
901698692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.71 |
| Max. Negotiated Rate |
$177.25 |
| Rate for Payer: Adventist Health Commercial |
$41.71
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.41
|
| Rate for Payer: EPIC Health Plan Senior |
$83.41
|
| Rate for Payer: Galaxy Health WC |
$177.25
|
| Rate for Payer: Global Benefits Group Commercial |
$125.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$132.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.05
|
| Rate for Payer: Multiplan Commercial |
$166.82
|
| Rate for Payer: Networks By Design Commercial |
$135.54
|
| Rate for Payer: Prime Health Services Commercial |
$177.25
|
|
|
HC CATH URINARY DRAIN SET 8FR
|
Facility
|
OP
|
$208.53
|
|
| Hospital Charge Code |
901698692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.71 |
| Max. Negotiated Rate |
$177.25 |
| Rate for Payer: Adventist Health Commercial |
$41.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$177.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$156.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.81
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cigna of CA HMO |
$133.46
|
| Rate for Payer: Cigna of CA PPO |
$154.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$177.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$177.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$177.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.41
|
| Rate for Payer: EPIC Health Plan Senior |
$83.41
|
| Rate for Payer: Galaxy Health WC |
$177.25
|
| Rate for Payer: Global Benefits Group Commercial |
$125.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$132.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$75.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145.97
|
| Rate for Payer: Multiplan Commercial |
$166.82
|
| Rate for Payer: Networks By Design Commercial |
$135.54
|
| Rate for Payer: Prime Health Services Commercial |
$177.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$125.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$125.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$104.27
|
| Rate for Payer: United Healthcare All Other HMO |
$104.27
|
| Rate for Payer: United Healthcare HMO Rider |
$104.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$104.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$177.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$177.25
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
|
|
HC CATH URINARY PEDS 6FR STRGHT
|
Facility
|
OP
|
$75.85
|
|
| Hospital Charge Code |
901603249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$64.47 |
| Rate for Payer: Adventist Health Commercial |
$15.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.67
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cigna of CA HMO |
$48.54
|
| Rate for Payer: Cigna of CA PPO |
$56.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.34
|
| Rate for Payer: EPIC Health Plan Senior |
$30.34
|
| Rate for Payer: Galaxy Health WC |
$64.47
|
| Rate for Payer: Global Benefits Group Commercial |
$45.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.09
|
| Rate for Payer: Multiplan Commercial |
$60.68
|
| Rate for Payer: Networks By Design Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Commercial |
$64.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$37.92
|
| Rate for Payer: United Healthcare All Other HMO |
$37.92
|
| Rate for Payer: United Healthcare HMO Rider |
$37.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.47
|
| Rate for Payer: Vantage Medical Group Senior |
$64.47
|
|
|
HC CATH URINARY PEDS 6FR STRGHT
|
Facility
|
IP
|
$75.85
|
|
| Hospital Charge Code |
901603249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$64.47 |
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Adventist Health Commercial |
$15.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.34
|
| Rate for Payer: EPIC Health Plan Senior |
$30.34
|
| Rate for Payer: Galaxy Health WC |
$64.47
|
| Rate for Payer: Global Benefits Group Commercial |
$45.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.20
|
| Rate for Payer: Multiplan Commercial |
$60.68
|
| Rate for Payer: Networks By Design Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Commercial |
$64.47
|
|
|
HC CATH, URINARY SILASTIC 5FR
|
Facility
|
IP
|
$138.02
|
|
| Hospital Charge Code |
901698448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.32 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.21
|
| Rate for Payer: EPIC Health Plan Senior |
$55.21
|
| Rate for Payer: Galaxy Health WC |
$117.32
|
| Rate for Payer: Global Benefits Group Commercial |
$82.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Multiplan Commercial |
$110.42
|
| Rate for Payer: Networks By Design Commercial |
$89.71
|
| Rate for Payer: Prime Health Services Commercial |
$117.32
|
|
|
HC CATH, URINARY SILASTIC 5FR
|
Facility
|
OP
|
$138.02
|
|
| Hospital Charge Code |
901698448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.32 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.57
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: Cigna of CA HMO |
$88.33
|
| Rate for Payer: Cigna of CA PPO |
$102.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.21
|
| Rate for Payer: EPIC Health Plan Senior |
$55.21
|
| Rate for Payer: Galaxy Health WC |
$117.32
|
| Rate for Payer: Global Benefits Group Commercial |
$82.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.61
|
| Rate for Payer: Multiplan Commercial |
$110.42
|
| Rate for Payer: Networks By Design Commercial |
$89.71
|
| Rate for Payer: Prime Health Services Commercial |
$117.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.01
|
| Rate for Payer: United Healthcare All Other HMO |
$69.01
|
| Rate for Payer: United Healthcare HMO Rider |
$69.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.32
|
| Rate for Payer: Vantage Medical Group Senior |
$117.32
|
|
|
HC CATH URINARY SYSTEM 10FR
|
Facility
|
OP
|
$18.37
|
|
| Hospital Charge Code |
901602923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.79
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Cigna of CA HMO |
$11.76
|
| Rate for Payer: Cigna of CA PPO |
$13.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.86
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.19
|
| Rate for Payer: United Healthcare All Other HMO |
$9.19
|
| Rate for Payer: United Healthcare HMO Rider |
$9.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.61
|
| Rate for Payer: Vantage Medical Group Senior |
$15.61
|
|
|
HC CATH URINARY SYSTEM 10FR
|
Facility
|
IP
|
$18.37
|
|
| Hospital Charge Code |
901602923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
|
|
HC CATH URINARY SYSTEM 14FR
|
Facility
|
OP
|
$18.37
|
|
| Hospital Charge Code |
901602924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.79
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Cigna of CA HMO |
$11.76
|
| Rate for Payer: Cigna of CA PPO |
$13.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.86
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.19
|
| Rate for Payer: United Healthcare All Other HMO |
$9.19
|
| Rate for Payer: United Healthcare HMO Rider |
$9.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.61
|
| Rate for Payer: Vantage Medical Group Senior |
$15.61
|
|
|
HC CATH URINARY SYSTEM 14FR
|
Facility
|
IP
|
$18.37
|
|
| Hospital Charge Code |
901602924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Adventist Health Commercial |
$3.67
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.35
|
| Rate for Payer: EPIC Health Plan Senior |
$7.35
|
| Rate for Payer: Galaxy Health WC |
$15.61
|
| Rate for Payer: Global Benefits Group Commercial |
$11.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Multiplan Commercial |
$14.70
|
| Rate for Payer: Networks By Design Commercial |
$11.94
|
| Rate for Payer: Prime Health Services Commercial |
$15.61
|
|
|
HC CATH URINARY SYSTEM 8FR
|
Facility
|
IP
|
$17.38
|
|
| Hospital Charge Code |
901602922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$14.77 |
| Rate for Payer: Adventist Health Commercial |
$3.48
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.95
|
| Rate for Payer: EPIC Health Plan Senior |
$6.95
|
| Rate for Payer: Galaxy Health WC |
$14.77
|
| Rate for Payer: Global Benefits Group Commercial |
$10.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.17
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
| Rate for Payer: Networks By Design Commercial |
$11.30
|
| Rate for Payer: Prime Health Services Commercial |
$14.77
|
|
|
HC CATH URINARY SYSTEM 8FR
|
Facility
|
OP
|
$17.38
|
|
| Hospital Charge Code |
901602922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$14.77 |
| Rate for Payer: Adventist Health Commercial |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.15
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Cigna of CA HMO |
$11.12
|
| Rate for Payer: Cigna of CA PPO |
$12.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.95
|
| Rate for Payer: EPIC Health Plan Senior |
$6.95
|
| Rate for Payer: Galaxy Health WC |
$14.77
|
| Rate for Payer: Global Benefits Group Commercial |
$10.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.17
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
| Rate for Payer: Networks By Design Commercial |
$11.30
|
| Rate for Payer: Prime Health Services Commercial |
$14.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.69
|
| Rate for Payer: United Healthcare All Other HMO |
$8.69
|
| Rate for Payer: United Healthcare HMO Rider |
$8.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.77
|
| Rate for Payer: Vantage Medical Group Senior |
$14.77
|
|
|
HC CATH VAPRO PLUS 14FR 16 IN
|
Facility
|
OP
|
$19.52
|
|
| Hospital Charge Code |
901607287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Adventist Health Commercial |
$3.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.53
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cigna of CA HMO |
$12.49
|
| Rate for Payer: Cigna of CA PPO |
$14.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.81
|
| Rate for Payer: EPIC Health Plan Senior |
$7.81
|
| Rate for Payer: Galaxy Health WC |
$16.59
|
| Rate for Payer: Global Benefits Group Commercial |
$11.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.66
|
| Rate for Payer: Multiplan Commercial |
$15.62
|
| Rate for Payer: Networks By Design Commercial |
$12.69
|
| Rate for Payer: Prime Health Services Commercial |
$16.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$16.59
|
|
