|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cigna of CA HMO |
$684.16
|
| Rate for Payer: Cigna of CA PPO |
$791.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$641.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$534.50
|
| Rate for Payer: United Healthcare All Other HMO |
$534.50
|
| Rate for Payer: United Healthcare HMO Rider |
$534.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$534.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$228.21 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$438.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$602.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cigna of CA HMO |
$684.16
|
| Rate for Payer: Cigna of CA PPO |
$791.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$641.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$641.40
|
| 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 |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$908.65 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: EPIC Health Plan Senior |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$630.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$908.65 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: EPIC Health Plan Senior |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$630.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$201.78 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$602.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cigna of CA HMO |
$684.16
|
| Rate for Payer: Cigna of CA PPO |
$791.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$201.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$641.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$641.40
|
| 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 |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$908.65 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: EPIC Health Plan Senior |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$630.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.78 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Cigna of CA PPO |
$791.06
|
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cigna of CA HMO |
$684.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$201.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$641.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$534.50
|
| 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: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC PUNCTURE ASPIR ABCESS/HEM/CYST
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
900501006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$908.65 |
| Rate for Payer: Adventist Health Commercial |
$213.80
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$748.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: EPIC Health Plan Senior |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$678.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$630.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.56
|
| Rate for Payer: Multiplan Commercial |
$855.20
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$2,022.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$404.40 |
| Max. Negotiated Rate |
$1,718.70 |
| Rate for Payer: Adventist Health Commercial |
$404.40
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,415.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$808.80
|
| Rate for Payer: EPIC Health Plan Senior |
$808.80
|
| Rate for Payer: Galaxy Health WC |
$1,718.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,192.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.28
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: Networks By Design Commercial |
$1,314.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,718.70
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$2,022.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$248.29 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$404.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Cigna of CA HMO |
$1,294.08
|
| Rate for Payer: Cigna of CA PPO |
$1,496.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,415.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,718.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$248.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$975.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,143.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,314.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,718.70
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,213.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,011.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,011.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,011.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,011.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
OP
|
$2,022.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$219.54 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$404.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| 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 |
$909.90
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Cigna of CA HMO |
$1,294.08
|
| Rate for Payer: Cigna of CA PPO |
$1,496.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,415.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$1,718.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$219.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$248.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,271.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,143.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,314.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,718.70
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,213.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,011.00
|
| 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 |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC PUNCTURE SHUNT TUBE
|
Facility
|
IP
|
$2,022.00
|
|
|
Service Code
|
CPT 61070
|
| Hospital Charge Code |
909000198
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$404.40 |
| Max. Negotiated Rate |
$1,718.70 |
| Rate for Payer: Adventist Health Commercial |
$404.40
|
| Rate for Payer: Cash Price |
$909.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,415.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$808.80
|
| Rate for Payer: EPIC Health Plan Senior |
$808.80
|
| Rate for Payer: Galaxy Health WC |
$1,718.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,283.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,192.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.28
|
| Rate for Payer: Multiplan Commercial |
$1,617.60
|
| Rate for Payer: Networks By Design Commercial |
$1,314.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,718.70
|
|
|
HC PURE TONE AUDIOMETRY; AIR AND BONE
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
908603070
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$351.90 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$237.14
|
| 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 |
$265.66
|
| Rate for Payer: Blue Shield of California Commercial |
$174.29
|
| Rate for Payer: Blue Shield of California Commercial |
$264.13
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cigna of CA HMO |
$264.96
|
| Rate for Payer: Cigna of CA PPO |
$306.36
|
| 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 |
$289.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.36
|
| 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 |
$331.20
|
| Rate for Payer: Networks By Design Commercial |
$269.10
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$248.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$226.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$168.00
|
| 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 PURE TONE AUDIOMETRY; AIR AND BONE
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
908603070
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$351.90 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Senior |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.36
|
| Rate for Payer: Multiplan Commercial |
$331.20
|
| Rate for Payer: Networks By Design Commercial |
$269.10
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
|
|
HC PVA PARTICLES
|
Facility
|
IP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cigna of CA HMO |
$788.90
|
| Rate for Payer: Cigna of CA PPO |
$788.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.80
|
| Rate for Payer: EPIC Health Plan Senior |
$450.80
|
| Rate for Payer: Galaxy Health WC |
$957.95
|
| Rate for Payer: Global Benefits Group Commercial |
$676.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.48
|
| Rate for Payer: Multiplan Commercial |
$901.60
|
| Rate for Payer: Networks By Design Commercial |
$563.50
|
| Rate for Payer: Prime Health Services Commercial |
$957.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.96
|
| Rate for Payer: United Healthcare All Other HMO |
$411.69
|
| Rate for Payer: United Healthcare HMO Rider |
$402.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.09
|
|
|
HC PVA PARTICLES
|
Facility
|
OP
|
$1,127.00
|
|
| Hospital Charge Code |
909081806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.40 |
| Max. Negotiated Rate |
$957.95 |
| Rate for Payer: Adventist Health Commercial |
$225.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$957.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$619.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$845.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$682.17
|
| Rate for Payer: Blue Shield of California Commercial |
$571.39
|
| Rate for Payer: Blue Shield of California Commercial |
$866.66
|
| Rate for Payer: Cash Price |
$507.15
|
| Rate for Payer: Cigna of CA HMO |
$788.90
|
| Rate for Payer: Cigna of CA PPO |
$788.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$957.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$957.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$957.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.80
|
| Rate for Payer: EPIC Health Plan Senior |
$450.80
|
| Rate for Payer: Galaxy Health WC |
$957.95
|
| Rate for Payer: Global Benefits Group Commercial |
$676.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$409.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$788.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$788.90
|
| Rate for Payer: Multiplan Commercial |
$901.60
|
| Rate for Payer: Networks By Design Commercial |
$563.50
|
| Rate for Payer: Prime Health Services Commercial |
$957.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$676.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$676.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$422.96
|
| Rate for Payer: United Healthcare All Other HMO |
$411.69
|
| Rate for Payer: United Healthcare HMO Rider |
$402.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$957.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$957.95
|
| Rate for Payer: Vantage Medical Group Senior |
$957.95
|
|
|
HC PWRWAND CATH ED STERILE 3FR
|
Facility
|
IP
|
$440.97
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$374.82 |
| Rate for Payer: Adventist Health Commercial |
$88.19
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.39
|
| Rate for Payer: EPIC Health Plan Senior |
$176.39
|
| Rate for Payer: Galaxy Health WC |
$374.82
|
| Rate for Payer: Global Benefits Group Commercial |
$264.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$280.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.83
|
| Rate for Payer: Multiplan Commercial |
$352.78
|
| Rate for Payer: Networks By Design Commercial |
$286.63
|
| Rate for Payer: Prime Health Services Commercial |
$374.82
|
|
|
HC PWRWAND CATH ED STERILE 3FR
|
Facility
|
OP
|
$440.97
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$88.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.97
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cigna of CA HMO |
$282.22
|
| Rate for Payer: Cigna of CA PPO |
$326.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.39
|
| Rate for Payer: EPIC Health Plan Senior |
$176.39
|
| Rate for Payer: Galaxy Health WC |
$374.82
|
| Rate for Payer: Global Benefits Group Commercial |
$264.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$280.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.68
|
| Rate for Payer: Multiplan Commercial |
$352.78
|
| Rate for Payer: Networks By Design Commercial |
$286.63
|
| Rate for Payer: Prime Health Services Commercial |
$374.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$220.49
|
| Rate for Payer: United Healthcare All Other HMO |
$220.49
|
| Rate for Payer: United Healthcare HMO Rider |
$220.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$220.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.82
|
| Rate for Payer: Vantage Medical Group Senior |
$374.82
|
|
|
HC PWRWAND XL 3FR 6CM QUICK KIT
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.93
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cigna of CA HMO |
$78.72
|
| Rate for Payer: Cigna of CA PPO |
$91.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO |
$61.50
|
| Rate for Payer: United Healthcare HMO Rider |
$61.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.55
|
| Rate for Payer: Vantage Medical Group Senior |
$104.55
|
|
|
HC PWRWAND XL 3FR 6CM QUICK KIT
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
|
|
HC PWRWAND XL 4FR 8CM QUICK KIT
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
|
|
HC PWRWAND XL 4FR 8CM QUICK KIT
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.93
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cigna of CA HMO |
$78.72
|
| Rate for Payer: Cigna of CA PPO |
$91.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.50
|
| Rate for Payer: United Healthcare All Other HMO |
$61.50
|
| Rate for Payer: United Healthcare HMO Rider |
$61.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.55
|
| Rate for Payer: Vantage Medical Group Senior |
$104.55
|
|
|
HC PWRWAND XL SINGLE 3FR, 6CM
|
Facility
|
IP
|
$417.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.52 |
| Max. Negotiated Rate |
$354.96 |
| Rate for Payer: Adventist Health Commercial |
$83.52
|
| Rate for Payer: Cash Price |
$187.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$292.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.04
|
| Rate for Payer: EPIC Health Plan Senior |
$167.04
|
| Rate for Payer: Galaxy Health WC |
$354.96
|
| Rate for Payer: Global Benefits Group Commercial |
$250.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$265.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$246.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.22
|
| Rate for Payer: Multiplan Commercial |
$334.08
|
| Rate for Payer: Networks By Design Commercial |
$271.44
|
| Rate for Payer: Prime Health Services Commercial |
$354.96
|
|
|
HC PWRWAND XL SINGLE 3FR, 6CM
|
Facility
|
OP
|
$417.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.52 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$83.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$354.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$313.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.97
|
| Rate for Payer: Cash Price |
$187.92
|
| Rate for Payer: Cash Price |
$187.92
|
| Rate for Payer: Cigna of CA HMO |
$267.26
|
| Rate for Payer: Cigna of CA PPO |
$309.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$354.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$354.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$354.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$292.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.04
|
| Rate for Payer: EPIC Health Plan Senior |
$167.04
|
| Rate for Payer: Galaxy Health WC |
$354.96
|
| Rate for Payer: Global Benefits Group Commercial |
$250.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$265.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$151.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$246.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$292.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$292.32
|
| Rate for Payer: Multiplan Commercial |
$334.08
|
| Rate for Payer: Networks By Design Commercial |
$271.44
|
| Rate for Payer: Prime Health Services Commercial |
$354.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$208.80
|
| Rate for Payer: United Healthcare All Other HMO |
$208.80
|
| Rate for Payer: United Healthcare HMO Rider |
$208.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$354.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$354.96
|
| Rate for Payer: Vantage Medical Group Senior |
$354.96
|
|
|
HC PWRWAND XL SINGLE 4FR, 8CM
|
Facility
|
IP
|
$574.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.84 |
| Max. Negotiated Rate |
$488.07 |
| Rate for Payer: Adventist Health Commercial |
$114.84
|
| Rate for Payer: Cash Price |
$258.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$401.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$229.68
|
| Rate for Payer: EPIC Health Plan Senior |
$229.68
|
| Rate for Payer: Galaxy Health WC |
$488.07
|
| Rate for Payer: Global Benefits Group Commercial |
$344.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$364.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$338.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.81
|
| Rate for Payer: Multiplan Commercial |
$459.36
|
| Rate for Payer: Networks By Design Commercial |
$373.23
|
| Rate for Payer: Prime Health Services Commercial |
$488.07
|
|
