|
HC COIL TERUMO AZUR 18D 4X15
|
Facility
|
OP
|
$3,318.00
|
|
| Hospital Charge Code |
906812599
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$663.60 |
| Max. Negotiated Rate |
$2,820.30 |
| Rate for Payer: Adventist Health Commercial |
$663.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,820.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,488.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,921.79
|
| Rate for Payer: Blue Shield of California Commercial |
$2,448.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,612.55
|
| Rate for Payer: Cash Price |
$1,493.10
|
| Rate for Payer: Cigna of CA HMO |
$2,322.60
|
| Rate for Payer: Cigna of CA PPO |
$2,322.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,820.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,820.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,820.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,327.20
|
| Rate for Payer: Galaxy Health WC |
$2,820.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,213.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,264.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,322.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,322.60
|
| Rate for Payer: Multiplan Commercial |
$2,654.40
|
| Rate for Payer: Networks By Design Commercial |
$1,659.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,820.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,245.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,212.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1,185.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,086.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,820.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,820.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,820.30
|
|
|
HC COIL TERUMO AZUR 18D 4X15
|
Facility
|
IP
|
$3,318.00
|
|
| Hospital Charge Code |
906812599
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$663.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$663.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,493.10
|
| Rate for Payer: Cash Price |
$1,493.10
|
| Rate for Payer: Cigna of CA HMO |
$2,322.60
|
| Rate for Payer: Cigna of CA PPO |
$2,322.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,327.20
|
| Rate for Payer: Galaxy Health WC |
$2,820.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,213.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,264.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.32
|
| Rate for Payer: Multiplan Commercial |
$2,654.40
|
| Rate for Payer: Networks By Design Commercial |
$1,659.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,820.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,245.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,212.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1,185.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,086.64
|
|
|
HC COIL TERUMO AZUR 18D 4X20
|
Facility
|
IP
|
$3,501.00
|
|
| Hospital Charge Code |
906812600
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$700.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cigna of CA HMO |
$2,450.70
|
| Rate for Payer: Cigna of CA PPO |
$2,450.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,400.40
|
| Rate for Payer: Galaxy Health WC |
$2,975.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,335.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,167.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$840.24
|
| Rate for Payer: Multiplan Commercial |
$2,800.80
|
| Rate for Payer: Networks By Design Commercial |
$1,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,313.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1,251.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,146.58
|
|
|
HC COIL TERUMO AZUR 18D 4X20
|
Facility
|
OP
|
$3,501.00
|
|
| Hospital Charge Code |
906812600
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.20 |
| Max. Negotiated Rate |
$2,975.85 |
| Rate for Payer: Adventist Health Commercial |
$700.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,925.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,625.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,027.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,583.74
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.49
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cigna of CA HMO |
$2,450.70
|
| Rate for Payer: Cigna of CA PPO |
$2,450.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,975.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,975.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,400.40
|
| Rate for Payer: Galaxy Health WC |
$2,975.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,335.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,167.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$840.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,450.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,450.70
|
| Rate for Payer: Multiplan Commercial |
$2,800.80
|
| Rate for Payer: Networks By Design Commercial |
$1,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,100.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,100.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,313.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1,251.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,146.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,975.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,975.85
|
|
|
HC COIL TERUMO AZUR 18D 4X5
|
Facility
|
IP
|
$2,917.00
|
|
| Hospital Charge Code |
906812594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
|
|
HC COIL TERUMO AZUR 18D 4X5
|
Facility
|
OP
|
$2,917.00
|
|
| Hospital Charge Code |
906812594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$2,479.45 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,604.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,187.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,689.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2,152.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,417.66
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,479.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,479.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,041.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,041.90
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,750.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,750.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,479.45
|
|
|
HC COIL TERUMO AZUR 18D 5X10
|
Facility
|
OP
|
$2,917.00
|
|
| Hospital Charge Code |
906812595
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$2,479.45 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,604.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,187.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,689.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2,152.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,417.66
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,479.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,479.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,041.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,041.90
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,750.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,750.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,479.45
|
|
|
HC COIL TERUMO AZUR 18D 5X10
|
Facility
|
IP
|
$2,917.00
|
|
| Hospital Charge Code |
906812595
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
|
|
HC COIL TERUMO AZUR 18D 5X20
|
Facility
|
IP
|
$2,917.00
|
|
| Hospital Charge Code |
906812596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
|
|
HC COIL TERUMO AZUR 18D 5X20
|
Facility
|
OP
|
$2,917.00
|
|
| Hospital Charge Code |
906812596
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$2,479.45 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,604.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,187.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,689.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2,152.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,417.66
|
| Rate for Payer: Cash Price |
$1,312.65
|
| Rate for Payer: Cigna of CA HMO |
$2,041.90
|
| Rate for Payer: Cigna of CA PPO |
$2,041.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,479.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,479.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,041.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,041.90
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,458.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,750.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,750.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,094.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,065.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1,042.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$955.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,479.45
|
|
|
HC COIL TERUMO AZUR 18D 6X10
|
Facility
|
IP
|
$3,100.00
|
|
| Hospital Charge Code |
906812598
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$620.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,395.00
|
| Rate for Payer: Cash Price |
$1,395.00
|
| Rate for Payer: Cigna of CA HMO |
$2,170.00
|
| Rate for Payer: Cigna of CA PPO |
$2,170.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.00
|
| Rate for Payer: Galaxy Health WC |
$2,635.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,067.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,918.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$744.00
|
| Rate for Payer: Multiplan Commercial |
$2,480.00
|
| Rate for Payer: Networks By Design Commercial |
$1,550.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,163.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,132.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1,107.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,015.25
|
|
|
HC COIL TERUMO AZUR 18D 6X10
|
Facility
|
OP
|
$3,100.00
|
|
| Hospital Charge Code |
906812598
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.00 |
| Max. Negotiated Rate |
$2,635.00 |
| Rate for Payer: Adventist Health Commercial |
$620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,635.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,705.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,325.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,795.52
|
| Rate for Payer: Blue Shield of California Commercial |
$2,287.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,506.60
|
| Rate for Payer: Cash Price |
$1,395.00
|
| Rate for Payer: Cigna of CA HMO |
$2,170.00
|
| Rate for Payer: Cigna of CA PPO |
$2,170.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,635.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,635.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,635.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.00
|
| Rate for Payer: Galaxy Health WC |
$2,635.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,067.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,918.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$744.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,170.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,170.00
|
| Rate for Payer: Multiplan Commercial |
$2,480.00
|
| Rate for Payer: Networks By Design Commercial |
$1,550.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,860.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,860.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,163.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,132.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1,107.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,015.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,635.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,635.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,635.00
|
|
|
HC COIL TERUMO AZUR 18D 6X20
|
Facility
|
IP
|
$3,501.00
|
|
| Hospital Charge Code |
906812601
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$700.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cigna of CA HMO |
$2,450.70
|
| Rate for Payer: Cigna of CA PPO |
$2,450.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,400.40
|
| Rate for Payer: Galaxy Health WC |
$2,975.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,335.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,167.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$840.24
|
| Rate for Payer: Multiplan Commercial |
$2,800.80
|
| Rate for Payer: Networks By Design Commercial |
$1,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,313.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1,251.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,146.58
|
|
|
HC COIL TERUMO AZUR 18D 6X20
|
Facility
|
OP
|
$3,501.00
|
|
| Hospital Charge Code |
906812601
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.20 |
| Max. Negotiated Rate |
$2,975.85 |
| Rate for Payer: Adventist Health Commercial |
$700.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,925.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,625.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,027.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,583.74
|
| Rate for Payer: Blue Shield of California EPN |
$1,701.49
|
| Rate for Payer: Cash Price |
$1,575.45
|
| Rate for Payer: Cigna of CA HMO |
$2,450.70
|
| Rate for Payer: Cigna of CA PPO |
$2,450.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,975.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,975.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,400.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,400.40
|
| Rate for Payer: Galaxy Health WC |
$2,975.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,335.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,333.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,167.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$840.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,450.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,450.70
|
| Rate for Payer: Multiplan Commercial |
$2,800.80
|
| Rate for Payer: Networks By Design Commercial |
$1,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,975.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,100.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,100.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,313.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1,251.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,146.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,975.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,975.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,975.85
|
|
|
HC COIL TERUMO AZUR 35D 4X10
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812591
|
|
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 |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 35D 4X10
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812591
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 35D 6X10
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812592
|
|
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 |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 35D 6X10
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812592
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 35D 6X20
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812593
|
|
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 |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 35D 6X20
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812593
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 3D 4X5
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812571
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR 3D 4X5
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812571
|
|
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 |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 COIL TERUMO AZUR CX 018 10X32
|
Facility
|
IP
|
$2,925.00
|
|
| Hospital Charge Code |
906812605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$585.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,316.25
|
| Rate for Payer: Cash Price |
$1,316.25
|
| Rate for Payer: Cigna of CA HMO |
$2,047.50
|
| Rate for Payer: Cigna of CA PPO |
$2,047.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,170.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,170.00
|
| Rate for Payer: Galaxy Health WC |
$2,486.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,755.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,950.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,810.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,486.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.94
|
|
|
HC COIL TERUMO AZUR CX 018 10X32
|
Facility
|
OP
|
$2,925.00
|
|
| Hospital Charge Code |
906812605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$2,486.25 |
| Rate for Payer: Adventist Health Commercial |
$585.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,608.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,193.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.16
|
| Rate for Payer: Blue Shield of California Commercial |
$2,158.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,421.55
|
| Rate for Payer: Cash Price |
$1,316.25
|
| Rate for Payer: Cigna of CA HMO |
$2,047.50
|
| Rate for Payer: Cigna of CA PPO |
$2,047.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,486.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,486.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,170.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,170.00
|
| Rate for Payer: Galaxy Health WC |
$2,486.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,755.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,950.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,810.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,047.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,047.50
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,486.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,755.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,755.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,486.25
|
|
|
HC COIL TERUMO AZUR CX 018 12X38
|
Facility
|
OP
|
$2,925.00
|
|
| Hospital Charge Code |
906812607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$2,486.25 |
| Rate for Payer: Adventist Health Commercial |
$585.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,608.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,193.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,694.16
|
| Rate for Payer: Blue Shield of California Commercial |
$2,158.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,421.55
|
| Rate for Payer: Cash Price |
$1,316.25
|
| Rate for Payer: Cigna of CA HMO |
$2,047.50
|
| Rate for Payer: Cigna of CA PPO |
$2,047.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,486.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,486.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,170.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,170.00
|
| Rate for Payer: Galaxy Health WC |
$2,486.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,755.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,950.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,114.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,810.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,047.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,047.50
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,486.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,755.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,755.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,486.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,486.25
|
|
