|
HC KIT CENTRAL VENOUS 4 LUMEN 8.5 FR,POWER INJ
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
IP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$122.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Senior |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$409.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$379.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.21
|
| Rate for Payer: Multiplan Commercial |
$490.69
|
| Rate for Payer: Networks By Design Commercial |
$306.68
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.19
|
| Rate for Payer: United Healthcare All Other HMO |
$224.06
|
| Rate for Payer: United Healthcare HMO Rider |
$219.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.88
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
OP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$521.36 |
| Rate for Payer: Adventist Health Commercial |
$122.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$521.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$460.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$355.26
|
| Rate for Payer: Blue Shield of California Commercial |
$452.66
|
| Rate for Payer: Blue Shield of California EPN |
$298.09
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$521.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$521.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$521.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Senior |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$409.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$379.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$429.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$429.35
|
| Rate for Payer: Multiplan Commercial |
$490.69
|
| Rate for Payer: Networks By Design Commercial |
$306.68
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$368.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$368.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.19
|
| Rate for Payer: United Healthcare All Other HMO |
$224.06
|
| Rate for Payer: United Healthcare HMO Rider |
$219.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$521.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$521.36
|
| Rate for Payer: Vantage Medical Group Senior |
$521.36
|
|
|
HC KIT CNTRL LINE CHANGE INFANT
|
Facility
|
OP
|
$85.27
|
|
| Hospital Charge Code |
901698193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$72.48 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.36
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cigna of CA HMO |
$54.57
|
| Rate for Payer: Cigna of CA PPO |
$63.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.69
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$55.43
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.63
|
| Rate for Payer: United Healthcare All Other HMO |
$42.63
|
| Rate for Payer: United Healthcare HMO Rider |
$42.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC KIT CNTRL LINE CHANGE INFANT
|
Facility
|
IP
|
$85.27
|
|
| Hospital Charge Code |
901698193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$72.48 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$55.43
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
|
|
HC KIT CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.18
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$32.80
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20.50
|
| Rate for Payer: United Healthcare HMO Rider |
$20.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34.85
|
|
|
HC KIT CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.84
|
| Rate for Payer: Multiplan Commercial |
$32.80
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
IP
|
$153.72
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$130.66 |
| Rate for Payer: Adventist Health Commercial |
$30.74
|
| Rate for Payer: Cash Price |
$69.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.49
|
| Rate for Payer: EPIC Health Plan Senior |
$61.49
|
| Rate for Payer: Galaxy Health WC |
$130.66
|
| Rate for Payer: Global Benefits Group Commercial |
$92.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.89
|
| Rate for Payer: Multiplan Commercial |
$122.98
|
| Rate for Payer: Networks By Design Commercial |
$99.92
|
| Rate for Payer: Prime Health Services Commercial |
$130.66
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
OP
|
$153.72
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$130.66 |
| Rate for Payer: Adventist Health Commercial |
$30.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$130.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$94.40
|
| Rate for Payer: Cash Price |
$69.17
|
| Rate for Payer: Cigna of CA HMO |
$98.38
|
| Rate for Payer: Cigna of CA PPO |
$113.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$130.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.49
|
| Rate for Payer: EPIC Health Plan Senior |
$61.49
|
| Rate for Payer: Galaxy Health WC |
$130.66
|
| Rate for Payer: Global Benefits Group Commercial |
$92.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$107.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107.60
|
| Rate for Payer: Multiplan Commercial |
$122.98
|
| Rate for Payer: Networks By Design Commercial |
$99.92
|
| Rate for Payer: Prime Health Services Commercial |
$130.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.86
|
| Rate for Payer: United Healthcare All Other HMO |
$76.86
|
| Rate for Payer: United Healthcare HMO Rider |
$76.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$130.66
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
OP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$238.18 |
| Rate for Payer: Adventist Health Commercial |
$56.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$183.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$238.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$210.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.08
|
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: Cigna of CA HMO |
$179.33
|
| Rate for Payer: Cigna of CA PPO |
$207.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$238.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$238.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: EPIC Health Plan Senior |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$196.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$196.15
|
| Rate for Payer: Multiplan Commercial |
$224.17
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.10
|
| Rate for Payer: United Healthcare All Other HMO |
$140.10
|
| Rate for Payer: United Healthcare HMO Rider |
$140.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$238.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.18
|
| Rate for Payer: Vantage Medical Group Senior |
$238.18
|
|
|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
IP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$238.18 |
| Rate for Payer: Adventist Health Commercial |
$56.04
|
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: EPIC Health Plan Senior |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.25
|
| Rate for Payer: Multiplan Commercial |
$224.17
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
|
|
HC KIT IAP MONITOR
|
Facility
|
OP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$433.20 |
| Rate for Payer: Adventist Health Commercial |
$101.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$334.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$433.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$280.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$382.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$312.98
|
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: Cigna of CA HMO |
$326.18
|
| Rate for Payer: Cigna of CA PPO |
$377.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$433.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$433.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$433.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: EPIC Health Plan Senior |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$315.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$356.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$356.75
|
| Rate for Payer: Multiplan Commercial |
$407.72
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$254.82
|
| Rate for Payer: United Healthcare All Other HMO |
$254.82
|
| Rate for Payer: United Healthcare HMO Rider |
$254.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$433.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$433.20
|
| Rate for Payer: Vantage Medical Group Senior |
$433.20
|
|
|
HC KIT IAP MONITOR
|
Facility
|
IP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$433.20 |
| Rate for Payer: Adventist Health Commercial |
$101.93
|
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: EPIC Health Plan Senior |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$315.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.32
|
| Rate for Payer: Multiplan Commercial |
$407.72
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
|
|
HC KIT INDR 3.5FR .018IN X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR 3.5FR .018IN X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$198.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.13
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$212.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 4FR .018IN DIA X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$198.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.13
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$212.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 4FR .018IN DIA X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 5FR .018IN DIA X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 5FR .018IN DIA X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$257.63 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$198.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.13
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$187.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$212.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$242.48
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INTRODUCER SHEATH 8.5FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698228
|
|
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 KIT INTRODUCER SHEATH 8.5FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698228
|
|
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
|
|
|
HC KIT PORT DRSNG CHG
|
Facility
|
OP
|
$152.00
|
|
| Hospital Charge Code |
901698218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.34
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$106.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106.40
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC KIT PORT DRSNG CHG
|
Facility
|
IP
|
$152.00
|
|
| Hospital Charge Code |
901698218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC KIT RESUSCITATION MURRIETA
|
Facility
|
IP
|
$255.64
|
|
| Hospital Charge Code |
901698319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$217.29 |
| Rate for Payer: Adventist Health Commercial |
$51.13
|
| Rate for Payer: Cash Price |
$115.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.26
|
| Rate for Payer: EPIC Health Plan Senior |
$102.26
|
| Rate for Payer: Galaxy Health WC |
$217.29
|
| Rate for Payer: Global Benefits Group Commercial |
$153.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$158.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.35
|
| Rate for Payer: Multiplan Commercial |
$204.51
|
| Rate for Payer: Networks By Design Commercial |
$166.17
|
| Rate for Payer: Prime Health Services Commercial |
$217.29
|
|
|
HC KIT RESUSCITATION MURRIETA
|
Facility
|
OP
|
$255.64
|
|
| Hospital Charge Code |
901698319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$217.29 |
| Rate for Payer: Adventist Health Commercial |
$51.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$167.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$217.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.99
|
| Rate for Payer: Cash Price |
$115.04
|
| Rate for Payer: Cigna of CA HMO |
$163.61
|
| Rate for Payer: Cigna of CA PPO |
$189.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$217.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.26
|
| Rate for Payer: EPIC Health Plan Senior |
$102.26
|
| Rate for Payer: Galaxy Health WC |
$217.29
|
| Rate for Payer: Global Benefits Group Commercial |
$153.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$158.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$178.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$178.95
|
| Rate for Payer: Multiplan Commercial |
$204.51
|
| Rate for Payer: Networks By Design Commercial |
$166.17
|
| Rate for Payer: Prime Health Services Commercial |
$217.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$153.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$153.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$127.82
|
| Rate for Payer: United Healthcare All Other HMO |
$127.82
|
| Rate for Payer: United Healthcare HMO Rider |
$127.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$127.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$217.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$217.29
|
| Rate for Payer: Vantage Medical Group Senior |
$217.29
|
|
