|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$77,865.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$97,437.00 |
| Rate for Payer: Adventist Health Commercial |
$15,573.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,371.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,164.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$35,039.25
|
| Rate for Payer: Cash Price |
$35,039.25
|
| Rate for Payer: Cash Price |
$35,039.25
|
| Rate for Payer: Cigna of CA HMO |
$49,833.60
|
| Rate for Payer: Cigna of CA PPO |
$57,620.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,408.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,371.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54,505.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,612.68
|
| Rate for Payer: EPIC Health Plan Senior |
$44,408.45
|
| Rate for Payer: Galaxy Health WC |
$66,185.25
|
| Rate for Payer: Global Benefits Group Commercial |
$46,719.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,208.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$855.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,371.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49,444.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$966.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56,519.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,687.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,867.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,097.57
|
| Rate for Payer: Multiplan Commercial |
$62,292.00
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$50,612.25
|
| Rate for Payer: Prime Health Services Commercial |
$66,185.25
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,719.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,932.50
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,371.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60,556.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,408.45
|
| Rate for Payer: Vantage Medical Group Senior |
$40,371.32
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
OP
|
$6,854.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$462.84 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,370.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Cigna of CA HMO |
$4,386.56
|
| Rate for Payer: Cigna of CA PPO |
$5,071.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,797.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$5,825.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,112.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$462.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,352.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$523.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,764.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,644.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,387.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$5,483.20
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$4,455.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,825.90
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,112.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,427.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
IP
|
$6,854.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,370.80 |
| Max. Negotiated Rate |
$5,825.90 |
| Rate for Payer: Adventist Health Commercial |
$1,370.80
|
| Rate for Payer: Cash Price |
$3,084.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,797.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,741.60
|
| Rate for Payer: Galaxy Health WC |
$5,825.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,112.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,352.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,043.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,644.96
|
| Rate for Payer: Multiplan Commercial |
$5,483.20
|
| Rate for Payer: Networks By Design Commercial |
$4,455.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,825.90
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,420.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$213.33 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$484.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cigna of CA HMO |
$1,573.00
|
| Rate for Payer: Cigna of CA PPO |
$1,790.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,694.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$213.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,536.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$1,936.00
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,452.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,452.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,210.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,420.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$484.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Cigna of CA HMO |
$1,548.80
|
| Rate for Payer: Cigna of CA PPO |
$1,790.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,694.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,536.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,176.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$1,936.00
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,452.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,210.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,210.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,210.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,210.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,420.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$484.00 |
| Max. Negotiated Rate |
$2,057.00 |
| Rate for Payer: Adventist Health Commercial |
$484.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,694.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$968.00
|
| Rate for Payer: EPIC Health Plan Senior |
$968.00
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,536.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,427.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Multiplan Commercial |
$1,936.00
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,420.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$484.00 |
| Max. Negotiated Rate |
$2,057.00 |
| Rate for Payer: Adventist Health Commercial |
$484.00
|
| Rate for Payer: Cash Price |
$1,089.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,694.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$968.00
|
| Rate for Payer: EPIC Health Plan Senior |
$968.00
|
| Rate for Payer: Galaxy Health WC |
$2,057.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,452.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,536.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,427.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.80
|
| Rate for Payer: Multiplan Commercial |
$1,936.00
|
| Rate for Payer: Networks By Design Commercial |
$1,573.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,057.00
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$861.05 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$405.20
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.12
|
| Rate for Payer: Multiplan Commercial |
$810.40
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$951.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$190.20 |
| Max. Negotiated Rate |
$808.35 |
| Rate for Payer: Adventist Health Commercial |
$190.20
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.40
|
| Rate for Payer: EPIC Health Plan Senior |
$380.40
|
| Rate for Payer: Galaxy Health WC |
$808.35
|
| Rate for Payer: Global Benefits Group Commercial |
$570.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$561.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.24
|
| Rate for Payer: Multiplan Commercial |
$760.80
|
| Rate for Payer: Networks By Design Commercial |
$618.15
|
| Rate for Payer: Prime Health Services Commercial |
$808.35
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.99 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$225.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cigna of CA HMO |
$648.32
|
| Rate for Payer: Cigna of CA PPO |
$749.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$166.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$810.40
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.50
|
| Rate for Payer: United Healthcare All Other HMO |
$506.50
|
| Rate for Payer: United Healthcare HMO Rider |
$506.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$951.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$171.12 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$190.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cigna of CA HMO |
$608.64
|
| Rate for Payer: Cigna of CA PPO |
$703.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$808.35
|
| Rate for Payer: Global Benefits Group Commercial |
$570.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$760.80
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$618.15
|
| Rate for Payer: Prime Health Services Commercial |
$808.35
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$570.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$475.50
|
| Rate for Payer: United Healthcare All Other HMO |
$475.50
|
| Rate for Payer: United Healthcare HMO Rider |
$475.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$475.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$951.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$171.12 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$389.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$225.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Cigna of CA HMO |
$608.64
|
| Rate for Payer: Cigna of CA PPO |
$703.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$808.35
|
| Rate for Payer: Global Benefits Group Commercial |
$570.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$760.80
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$618.15
|
| Rate for Payer: Prime Health Services Commercial |
$808.35
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$570.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$570.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$951.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$190.20 |
| Max. Negotiated Rate |
$808.35 |
| Rate for Payer: Adventist Health Commercial |
$190.20
|
| Rate for Payer: Cash Price |
$427.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.40
|
| Rate for Payer: EPIC Health Plan Senior |
$380.40
|
| Rate for Payer: Galaxy Health WC |
$808.35
|
| Rate for Payer: Global Benefits Group Commercial |
$570.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$561.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$228.24
|
| Rate for Payer: Multiplan Commercial |
$760.80
|
| Rate for Payer: Networks By Design Commercial |
$618.15
|
| Rate for Payer: Prime Health Services Commercial |
$808.35
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
IP
|
$7,381.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,476.20 |
| Max. Negotiated Rate |
$6,273.85 |
| Rate for Payer: Adventist Health Commercial |
$1,476.20
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,166.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,952.40
|
| Rate for Payer: Galaxy Health WC |
$6,273.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,428.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,686.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,354.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,771.44
|
| Rate for Payer: Multiplan Commercial |
$5,904.80
|
| Rate for Payer: Networks By Design Commercial |
$4,797.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,273.85
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$7,381.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.71 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,476.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cigna of CA HMO |
$4,723.84
|
| Rate for Payer: Cigna of CA PPO |
$5,461.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,166.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$6,273.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,428.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$439.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,686.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$497.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,771.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$5,904.80
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$4,797.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,273.85
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,428.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,690.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$725.05 |
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$341.20
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$609.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cigna of CA HMO |
$545.92
|
| Rate for Payer: Cigna of CA PPO |
$631.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$426.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.50
|
| Rate for Payer: United Healthcare HMO Rider |
$426.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$426.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$725.05 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$341.20
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cigna of CA HMO |
$545.92
|
| Rate for Payer: Cigna of CA PPO |
$631.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Multiplan WC |
$316.75
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
| Rate for Payer: Prime Health Services WC |
$313.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$426.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.50
|
| Rate for Payer: United Healthcare HMO Rider |
$426.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$426.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$725.05 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$341.20
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$170.60 |
| Max. Negotiated Rate |
$725.05 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$341.20
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$349.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$609.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cigna of CA HMO |
$545.92
|
| Rate for Payer: Cigna of CA PPO |
$631.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Multiplan WC |
$316.75
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
| Rate for Payer: Prime Health Services WC |
$313.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$853.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$170.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$609.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cigna of CA HMO |
$545.92
|
| Rate for Payer: Cigna of CA PPO |
$631.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$597.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$725.05
|
| Rate for Payer: Global Benefits Group Commercial |
$511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$682.40
|
| Rate for Payer: Networks By Design Commercial |
$554.45
|
| Rate for Payer: Prime Health Services Commercial |
$725.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$14,691.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,938.20 |
| Max. Negotiated Rate |
$12,487.35 |
| Rate for Payer: Adventist Health Commercial |
$2,938.20
|
| Rate for Payer: Cash Price |
$6,610.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,283.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,876.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,876.40
|
| Rate for Payer: Galaxy Health WC |
$12,487.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,814.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,328.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,667.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,525.84
|
| Rate for Payer: Multiplan Commercial |
$11,752.80
|
| Rate for Payer: Networks By Design Commercial |
$9,549.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,487.35
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$14,691.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$589.81 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,938.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,487.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,080.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,018.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,472.51
|
| Rate for Payer: Blue Shield of California Commercial |
$5,596.61
|
| Rate for Payer: Cash Price |
$6,610.95
|
| Rate for Payer: Cash Price |
$6,610.95
|
| Rate for Payer: Cash Price |
$6,610.95
|
| Rate for Payer: Cigna of CA HMO |
$9,402.24
|
| Rate for Payer: Cigna of CA PPO |
$10,871.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,487.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,487.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,487.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,283.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,876.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,876.40
|
| Rate for Payer: Galaxy Health WC |
$12,487.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,814.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$589.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,328.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$667.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,667.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,525.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,283.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,283.70
|
| Rate for Payer: Multiplan Commercial |
$11,752.80
|
| Rate for Payer: Networks By Design Commercial |
$9,549.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,487.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,814.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,345.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,487.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,487.35
|
| Rate for Payer: Vantage Medical Group Senior |
$12,487.35
|
|
