|
HC INTRAVSCLR US INIT NONCOR VSSL
|
Facility
|
IP
|
$943.00
|
|
|
Service Code
|
CPT 37252
|
| Hospital Charge Code |
909037252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$801.55 |
| Rate for Payer: Adventist Health Commercial |
$188.60
|
| Rate for Payer: Cash Price |
$424.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$660.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.20
|
| Rate for Payer: EPIC Health Plan Senior |
$377.20
|
| Rate for Payer: Galaxy Health WC |
$801.55
|
| Rate for Payer: Global Benefits Group Commercial |
$565.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$598.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$556.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.32
|
| Rate for Payer: Multiplan Commercial |
$754.40
|
| Rate for Payer: Networks By Design Commercial |
$612.95
|
| Rate for Payer: Prime Health Services Commercial |
$801.55
|
|
|
HC INTRCRNL INF NON THROM EA ADD
|
Facility
|
OP
|
$1,791.00
|
|
|
Service Code
|
CPT 61651
|
| Hospital Charge Code |
909061651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$316.48 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$358.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,522.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$985.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,343.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$805.95
|
| Rate for Payer: Cash Price |
$805.95
|
| Rate for Payer: Cash Price |
$805.95
|
| Rate for Payer: Cigna of CA HMO |
$1,146.24
|
| Rate for Payer: Cigna of CA PPO |
$1,325.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,522.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,522.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,522.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,253.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$716.40
|
| Rate for Payer: EPIC Health Plan Senior |
$716.40
|
| Rate for Payer: Galaxy Health WC |
$1,522.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,074.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$316.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,137.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$357.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,056.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,253.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,253.70
|
| Rate for Payer: Multiplan Commercial |
$1,432.80
|
| Rate for Payer: Networks By Design Commercial |
$1,164.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,522.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,074.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$895.50
|
| 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 |
$1,522.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,522.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,522.35
|
|
|
HC INTRCRNL INF NON THROM EA ADD
|
Facility
|
IP
|
$1,791.00
|
|
|
Service Code
|
CPT 61651
|
| Hospital Charge Code |
909061651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$358.20 |
| Max. Negotiated Rate |
$1,522.35 |
| Rate for Payer: Adventist Health Commercial |
$358.20
|
| Rate for Payer: Cash Price |
$805.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,253.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$716.40
|
| Rate for Payer: EPIC Health Plan Senior |
$716.40
|
| Rate for Payer: Galaxy Health WC |
$1,522.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,074.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,137.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,056.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.84
|
| Rate for Payer: Multiplan Commercial |
$1,432.80
|
| Rate for Payer: Networks By Design Commercial |
$1,164.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,522.35
|
|
|
HC INTR NDL/INRCTH CRTD/VERT ART
|
Facility
|
IP
|
$1,174.00
|
|
|
Service Code
|
CPT 36100
|
| Hospital Charge Code |
909036100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$234.80 |
| Max. Negotiated Rate |
$997.90 |
| Rate for Payer: Adventist Health Commercial |
$234.80
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$821.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$469.60
|
| Rate for Payer: EPIC Health Plan Senior |
$469.60
|
| Rate for Payer: Galaxy Health WC |
$997.90
|
| Rate for Payer: Global Benefits Group Commercial |
$704.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$745.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$692.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.76
|
| Rate for Payer: Multiplan Commercial |
$939.20
|
| Rate for Payer: Networks By Design Commercial |
$763.10
|
| Rate for Payer: Prime Health Services Commercial |
$997.90
|
|
|
HC INTR NDL/INRCTH CRTD/VERT ART
|
Facility
|
OP
|
$1,174.00
|
|
|
Service Code
|
CPT 36100
|
| Hospital Charge Code |
909036100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$234.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Multiplan Commercial |
$939.20
|
| Rate for Payer: Adventist Health Commercial |
$234.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$997.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$645.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$880.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cash Price |
$528.30
|
| Rate for Payer: Cigna of CA HMO |
$751.36
|
| Rate for Payer: Cigna of CA PPO |
$868.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$997.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$997.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$997.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$821.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$469.60
|
| Rate for Payer: EPIC Health Plan Senior |
$469.60
|
| Rate for Payer: Galaxy Health WC |
$997.90
|
| Rate for Payer: Global Benefits Group Commercial |
$704.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$312.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$745.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$353.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$692.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$821.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$821.80
|
| Rate for Payer: Networks By Design Commercial |
$763.10
|
| Rate for Payer: Prime Health Services Commercial |
$997.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$704.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$587.00
|
| 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 |
$997.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$997.90
|
| Rate for Payer: Vantage Medical Group Senior |
$997.90
|
|
|
HC INTRO AGENT/PACK VAGINAL HEMOR
|
Facility
|
IP
|
$1,171.00
|
|
|
Service Code
|
CPT 57180
|
| Hospital Charge Code |
900501470
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$234.20 |
| Max. Negotiated Rate |
$995.35 |
| Rate for Payer: Adventist Health Commercial |
$234.20
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.40
|
| Rate for Payer: EPIC Health Plan Senior |
$468.40
|
| Rate for Payer: Galaxy Health WC |
$995.35
|
| Rate for Payer: Global Benefits Group Commercial |
$702.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$743.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.04
|
| Rate for Payer: Multiplan Commercial |
$936.80
|
| Rate for Payer: Networks By Design Commercial |
$761.15
|
| Rate for Payer: Prime Health Services Commercial |
$995.35
|
|
|
HC INTRO AGENT/PACK VAGINAL HEMOR
|
Facility
|
OP
|
$1,171.00
|
|
|
Service Code
|
CPT 57180
|
| Hospital Charge Code |
900501470
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$122.27 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$234.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Cigna of CA HMO |
$749.44
|
| Rate for Payer: Cigna of CA PPO |
$866.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$995.35
|
| Rate for Payer: Global Benefits Group Commercial |
$702.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$743.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$122.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$936.80
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$761.15
|
| Rate for Payer: Prime Health Services Commercial |
$995.35
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$585.50
|
| Rate for Payer: United Healthcare All Other HMO |
$585.50
|
| Rate for Payer: United Healthcare HMO Rider |
$585.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$585.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC INTRO CATH DIALYSIS CIRCUIT
|
Facility
|
IP
|
$2,363.00
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
909036901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.60 |
| Max. Negotiated Rate |
$2,008.55 |
| Rate for Payer: Adventist Health Commercial |
$472.60
|
| Rate for Payer: Cash Price |
$1,063.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,654.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$945.20
|
| Rate for Payer: EPIC Health Plan Senior |
$945.20
|
| Rate for Payer: Galaxy Health WC |
$2,008.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,417.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,500.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,394.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.12
|
| Rate for Payer: Multiplan Commercial |
$1,890.40
|
| Rate for Payer: Networks By Design Commercial |
$1,535.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,008.55
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$472.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| 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 |
$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 |
$1,654.10
|
| 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 |
$2,008.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,417.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$870.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,500.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$984.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.12
|
| 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 |
$1,890.40
|
| 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 |
$1,181.50
|
| 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 |
$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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$361.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$336.30
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$114.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$399.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$361.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$336.30
|
| 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 |
$285.00
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$671.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$608.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$565.81
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$671.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$608.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$565.81
|
| 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 |
$479.50
|
| 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 |
$266.83 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$266.83
|
| 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 |
$52.62
|
| Rate for Payer: Cash Price |
$36.90
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.27
|
| 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 Foundation Hospitals Commercial/Self Funded |
$48.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.90
|
| 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 |
$266.83 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$266.83
|
| 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 |
$48.83
|
| Rate for Payer: Cash Price |
$34.24
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.27
|
| 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 Foundation Hospitals Commercial/Self Funded |
$48.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.90
|
| 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
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.98 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$900.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$816.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$758.74
|
| 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 |
$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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$900.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$816.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$758.74
|
| 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
|
OP
|
$1,286.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$257.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| 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 |
$5,641.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$900.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$816.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$758.74
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$900.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$816.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$758.74
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| 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 |
$266.83 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$266.83
|
| 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 |
$85.99
|
| Rate for Payer: Cash Price |
$60.30
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.71
|
| 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 Foundation Hospitals Commercial/Self Funded |
$230.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.84
|
| 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 1.4FR
|
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 |
$266.83
|
| 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 |
$232.58
|
| Rate for Payer: Cash Price |
$163.10
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.71
|
| 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 Foundation Hospitals Commercial/Self Funded |
$230.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.84
|
| 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
|
|
