|
HC INTRO CATH DIALYSIS CIRCUIT
|
Facility
|
OP
|
$2,363.00
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
909036901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.60 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Adventist Health Commercial |
$472.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$1,063.35
|
| Rate for Payer: Cash Price |
$1,063.35
|
| Rate for Payer: Cash Price |
$1,063.35
|
| Rate for Payer: Cigna of CA HMO |
$1,512.32
|
| Rate for Payer: Cigna of CA PPO |
$1,748.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$2,008.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,417.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$870.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,576.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$984.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$1,890.40
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$1,535.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,008.55
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,417.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INTRO CATH RHRT/ MAIN PULM ART
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
909081311
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$114.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$484.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$427.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cigna of CA HMO |
$364.80
|
| Rate for Payer: Cigna of CA PPO |
$421.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$484.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$484.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$484.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.00
|
| Rate for Payer: EPIC Health Plan Senior |
$228.00
|
| Rate for Payer: Galaxy Health WC |
$484.50
|
| Rate for Payer: Global Benefits Group Commercial |
$342.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$135.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$380.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$352.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$399.00
|
| Rate for Payer: Multiplan Commercial |
$456.00
|
| Rate for Payer: Networks By Design Commercial |
$370.50
|
| Rate for Payer: Prime Health Services Commercial |
$484.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$342.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$484.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$484.50
|
| Rate for Payer: Vantage Medical Group Senior |
$484.50
|
|
|
HC INTRO CATH RHRT/ MAIN PULM ART
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
909081311
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: Adventist Health Commercial |
$114.00
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.00
|
| Rate for Payer: EPIC Health Plan Senior |
$228.00
|
| Rate for Payer: Galaxy Health WC |
$484.50
|
| Rate for Payer: Global Benefits Group Commercial |
$342.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$380.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$352.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$456.00
|
| Rate for Payer: Networks By Design Commercial |
$370.50
|
| Rate for Payer: Prime Health Services Commercial |
$484.50
|
|
|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
IP
|
$959.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.80 |
| Max. Negotiated Rate |
$815.15 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Cash Price |
$431.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$383.60
|
| Rate for Payer: EPIC Health Plan Senior |
$383.60
|
| Rate for Payer: Galaxy Health WC |
$815.15
|
| Rate for Payer: Global Benefits Group Commercial |
$575.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$639.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$365.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$593.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.16
|
| Rate for Payer: Multiplan Commercial |
$767.20
|
| Rate for Payer: Networks By Design Commercial |
$623.35
|
| Rate for Payer: Prime Health Services Commercial |
$815.15
|
|
|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
OP
|
$959.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.98 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$815.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$719.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$431.55
|
| Rate for Payer: Cash Price |
$431.55
|
| Rate for Payer: Cash Price |
$431.55
|
| Rate for Payer: Cigna of CA HMO |
$613.76
|
| Rate for Payer: Cigna of CA PPO |
$709.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$815.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$815.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$815.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$383.60
|
| Rate for Payer: EPIC Health Plan Senior |
$383.60
|
| Rate for Payer: Galaxy Health WC |
$815.15
|
| Rate for Payer: Global Benefits Group Commercial |
$575.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$639.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$593.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$671.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$671.30
|
| Rate for Payer: Multiplan Commercial |
$767.20
|
| Rate for Payer: Networks By Design Commercial |
$623.35
|
| Rate for Payer: Prime Health Services Commercial |
$815.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$575.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$815.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$815.15
|
| Rate for Payer: Vantage Medical Group Senior |
$815.15
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.36
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
IP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.26
|
| Rate for Payer: Multiplan Commercial |
$60.88
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
OP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.73
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Cigna of CA HMO |
$48.70
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.27
|
| Rate for Payer: Multiplan Commercial |
$60.88
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.05
|
| Rate for Payer: United Healthcare All Other HMO |
$38.05
|
| Rate for Payer: United Healthcare HMO Rider |
$38.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.69
|
| Rate for Payer: Vantage Medical Group Senior |
$64.69
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,740.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
906820183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.98 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$957.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,305.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Cigna of CA HMO |
$1,113.60
|
| Rate for Payer: Cigna of CA PPO |
$1,287.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,479.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,479.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,218.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,218.00
|
| Rate for Payer: Multiplan Commercial |
$1,392.00
|
| Rate for Payer: Networks By Design Commercial |
$1,131.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,479.00
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$707.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$964.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cigna of CA HMO |
$823.04
|
| Rate for Payer: Cigna of CA PPO |
$951.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,093.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,093.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.40
|
| Rate for Payer: EPIC Health Plan Senior |
$514.40
|
| Rate for Payer: Galaxy Health WC |
$1,093.10
|
| Rate for Payer: Global Benefits Group Commercial |
$771.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$857.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$900.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$900.20
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: Networks By Design Commercial |
$835.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,093.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$771.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$643.00
|
| Rate for Payer: United Healthcare All Other HMO |
$643.00
|
| Rate for Payer: United Healthcare HMO Rider |
$643.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,093.10
|
| Rate for Payer: Vantage Medical Group Senior |
$1,093.10
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.98 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$707.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$964.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: Cigna of CA HMO |
$823.04
|
| Rate for Payer: Cigna of CA PPO |
$951.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,093.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,093.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.40
|
| Rate for Payer: EPIC Health Plan Senior |
$514.40
|
| Rate for Payer: Galaxy Health WC |
$1,093.10
|
| Rate for Payer: Global Benefits Group Commercial |
$771.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$857.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$900.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$900.20
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: Networks By Design Commercial |
$835.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,093.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$771.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,093.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,093.10
|
| Rate for Payer: Vantage Medical Group Senior |
$1,093.10
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.20 |
| Max. Negotiated Rate |
$1,093.10 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.40
|
| Rate for Payer: EPIC Health Plan Senior |
$514.40
|
| Rate for Payer: Galaxy Health WC |
$1,093.10
|
| Rate for Payer: Global Benefits Group Commercial |
$771.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$857.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$489.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.64
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: Networks By Design Commercial |
$835.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,093.10
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$257.20 |
| Max. Negotiated Rate |
$1,093.10 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Cash Price |
$578.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.40
|
| Rate for Payer: EPIC Health Plan Senior |
$514.40
|
| Rate for Payer: Galaxy Health WC |
$1,093.10
|
| Rate for Payer: Global Benefits Group Commercial |
$771.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$857.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$489.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$796.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.64
|
| Rate for Payer: Multiplan Commercial |
$1,028.80
|
| Rate for Payer: Networks By Design Commercial |
$835.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,093.10
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,740.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
906820183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,479.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.60
|
| Rate for Payer: Multiplan Commercial |
$1,392.00
|
| Rate for Payer: Networks By Design Commercial |
$1,131.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.29
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67.00
|
| Rate for Payer: United Healthcare HMO Rider |
$67.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
OP
|
$362.44
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.49 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Adventist Health Commercial |
$72.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$237.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$308.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$199.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$271.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$222.57
|
| Rate for Payer: Cash Price |
$163.10
|
| Rate for Payer: Cigna of CA HMO |
$231.96
|
| Rate for Payer: Cigna of CA PPO |
$268.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$308.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$308.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$308.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.98
|
| Rate for Payer: EPIC Health Plan Senior |
$144.98
|
| Rate for Payer: Galaxy Health WC |
$308.07
|
| Rate for Payer: Global Benefits Group Commercial |
$217.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$224.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$253.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$253.71
|
| Rate for Payer: Multiplan Commercial |
$289.95
|
| Rate for Payer: Networks By Design Commercial |
$235.59
|
| Rate for Payer: Prime Health Services Commercial |
$308.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$217.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$217.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.22
|
| Rate for Payer: United Healthcare All Other HMO |
$181.22
|
| Rate for Payer: United Healthcare HMO Rider |
$181.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$181.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$308.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$308.07
|
| Rate for Payer: Vantage Medical Group Senior |
$308.07
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
IP
|
$362.44
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.49 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Adventist Health Commercial |
$72.49
|
| Rate for Payer: Cash Price |
$163.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.98
|
| Rate for Payer: EPIC Health Plan Senior |
$144.98
|
| Rate for Payer: Galaxy Health WC |
$308.07
|
| Rate for Payer: Global Benefits Group Commercial |
$217.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$224.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.99
|
| Rate for Payer: Multiplan Commercial |
$289.95
|
| Rate for Payer: Networks By Design Commercial |
$235.59
|
| Rate for Payer: Prime Health Services Commercial |
$308.07
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$197.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.84
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$210.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$210.70
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.50
|
| Rate for Payer: United Healthcare All Other HMO |
$150.50
|
| Rate for Payer: United Healthcare HMO Rider |
$150.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
IP
|
$310.80
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.16 |
| Max. Negotiated Rate |
$264.18 |
| Rate for Payer: Adventist Health Commercial |
$62.16
|
| Rate for Payer: Cash Price |
$139.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.32
|
| Rate for Payer: EPIC Health Plan Senior |
$124.32
|
| Rate for Payer: Galaxy Health WC |
$264.18
|
| Rate for Payer: Global Benefits Group Commercial |
$186.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$207.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$192.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.59
|
| Rate for Payer: Multiplan Commercial |
$248.64
|
| Rate for Payer: Networks By Design Commercial |
$202.02
|
| Rate for Payer: Prime Health Services Commercial |
$264.18
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
OP
|
$310.80
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.16 |
| Max. Negotiated Rate |
$264.18 |
| Rate for Payer: Adventist Health Commercial |
$62.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$203.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$264.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$170.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$233.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.86
|
| Rate for Payer: Cash Price |
$139.86
|
| Rate for Payer: Cigna of CA HMO |
$198.91
|
| Rate for Payer: Cigna of CA PPO |
$229.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$264.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$264.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$264.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.32
|
| Rate for Payer: EPIC Health Plan Senior |
$124.32
|
| Rate for Payer: Galaxy Health WC |
$264.18
|
| Rate for Payer: Global Benefits Group Commercial |
$186.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$207.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$192.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$217.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$217.56
|
| Rate for Payer: Multiplan Commercial |
$248.64
|
| Rate for Payer: Networks By Design Commercial |
$202.02
|
| Rate for Payer: Prime Health Services Commercial |
$264.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$186.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$186.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.40
|
| Rate for Payer: United Healthcare All Other HMO |
$155.40
|
| Rate for Payer: United Healthcare HMO Rider |
$155.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$155.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$264.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$264.18
|
| Rate for Payer: Vantage Medical Group Senior |
$264.18
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$229.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.94
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
