|
HC TRAY CATH SLCN 16FR URN MTR
|
Facility
|
OP
|
$195.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$176.27 |
| Rate for Payer: Adventist Health Commercial |
$39.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$146.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.93
|
| Rate for Payer: Blue Shield of California Commercial |
$124.18
|
| Rate for Payer: Blue Shield of California EPN |
$78.15
|
| Rate for Payer: Cash Price |
$88.14
|
| Rate for Payer: Cash Price |
$88.14
|
| Rate for Payer: Central Health Plan Commercial |
$156.69
|
| Rate for Payer: Cigna of CA HMO |
$125.35
|
| Rate for Payer: Cigna of CA PPO |
$144.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.34
|
| Rate for Payer: EPIC Health Plan Senior |
$78.34
|
| Rate for Payer: Galaxy Health WC |
$166.48
|
| Rate for Payer: Global Benefits Group Commercial |
$117.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.10
|
| Rate for Payer: Multiplan Commercial |
$146.90
|
| Rate for Payer: Networks By Design Commercial |
$127.31
|
| Rate for Payer: Prime Health Services Commercial |
$166.48
|
| Rate for Payer: Riverside University Health System MISP |
$78.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.93
|
| Rate for Payer: United Healthcare All Other HMO |
$97.93
|
| Rate for Payer: United Healthcare HMO Rider |
$97.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.48
|
| Rate for Payer: Vantage Medical Group Senior |
$166.48
|
|
|
HC TRAY CATH SLCN 18FR URN MTR
|
Facility
|
IP
|
$125.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.17 |
| Max. Negotiated Rate |
$113.27 |
| Rate for Payer: Adventist Health Commercial |
$25.17
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Central Health Plan Commercial |
$100.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.34
|
| Rate for Payer: EPIC Health Plan Senior |
$50.34
|
| Rate for Payer: Galaxy Health WC |
$106.98
|
| Rate for Payer: Global Benefits Group Commercial |
$75.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.17
|
| Rate for Payer: Multiplan Commercial |
$94.39
|
| Rate for Payer: Networks By Design Commercial |
$81.81
|
| Rate for Payer: Prime Health Services Commercial |
$106.98
|
|
|
HC TRAY CATH SLCN 18FR URN MTR
|
Facility
|
OP
|
$125.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$113.27 |
| Rate for Payer: Adventist Health Commercial |
$25.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.21
|
| Rate for Payer: Blue Shield of California Commercial |
$79.80
|
| Rate for Payer: Blue Shield of California EPN |
$50.22
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Central Health Plan Commercial |
$100.69
|
| Rate for Payer: Cigna of CA HMO |
$80.55
|
| Rate for Payer: Cigna of CA PPO |
$93.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.34
|
| Rate for Payer: EPIC Health Plan Senior |
$50.34
|
| Rate for Payer: Galaxy Health WC |
$106.98
|
| Rate for Payer: Global Benefits Group Commercial |
$75.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$88.10
|
| Rate for Payer: Multiplan Commercial |
$94.39
|
| Rate for Payer: Networks By Design Commercial |
$81.81
|
| Rate for Payer: Prime Health Services Commercial |
$106.98
|
| Rate for Payer: Riverside University Health System MISP |
$50.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.93
|
| Rate for Payer: United Healthcare All Other HMO |
$62.93
|
| Rate for Payer: United Healthcare HMO Rider |
$62.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.98
|
| Rate for Payer: Vantage Medical Group Senior |
$106.98
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
|
OP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Adventist Health Commercial |
$19.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.09
|
| Rate for Payer: Blue Shield of California Commercial |
$63.31
|
| Rate for Payer: Blue Shield of California EPN |
$39.84
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Central Health Plan Commercial |
$79.89
|
| Rate for Payer: Cigna of CA HMO |
$63.91
|
| Rate for Payer: Cigna of CA PPO |
$73.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: EPIC Health Plan Senior |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$69.90
|
| Rate for Payer: Multiplan Commercial |
$74.89
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
| Rate for Payer: Riverside University Health System MISP |
$39.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.93
|
| Rate for Payer: United Healthcare All Other HMO |
$49.93
|
| Rate for Payer: United Healthcare HMO Rider |
$49.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.88
|
| Rate for Payer: Vantage Medical Group Senior |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
|
IP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Adventist Health Commercial |
$19.97
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Central Health Plan Commercial |
$79.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: EPIC Health Plan Senior |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.97
|
| Rate for Payer: Multiplan Commercial |
$74.89
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
|
OP
|
$123.04
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.61 |
| Max. Negotiated Rate |
$110.74 |
| Rate for Payer: Adventist Health Commercial |
$24.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.57
|
| Rate for Payer: Blue Shield of California Commercial |
$78.01
|
| Rate for Payer: Blue Shield of California EPN |
$49.09
|
| Rate for Payer: Cash Price |
$55.37
|
| Rate for Payer: Central Health Plan Commercial |
$98.43
|
| Rate for Payer: Cigna of CA HMO |
$78.75
|
| Rate for Payer: Cigna of CA PPO |
$91.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.22
|
| Rate for Payer: EPIC Health Plan Senior |
$49.22
|
| Rate for Payer: Galaxy Health WC |
$104.58
|
| Rate for Payer: Global Benefits Group Commercial |
$73.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.13
|
| Rate for Payer: Multiplan Commercial |
$92.28
|
| Rate for Payer: Networks By Design Commercial |
$79.98
|
| Rate for Payer: Prime Health Services Commercial |
$104.58
|
| Rate for Payer: Riverside University Health System MISP |
$49.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.52
|
| Rate for Payer: United Healthcare All Other HMO |
$61.52
|
| Rate for Payer: United Healthcare HMO Rider |
$61.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.58
|
| Rate for Payer: Vantage Medical Group Senior |
$104.58
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
|
IP
|
$123.04
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.61 |
| Max. Negotiated Rate |
$110.74 |
| Rate for Payer: Adventist Health Commercial |
$24.61
|
| Rate for Payer: Cash Price |
$55.37
|
| Rate for Payer: Central Health Plan Commercial |
$98.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.22
|
| Rate for Payer: EPIC Health Plan Senior |
$49.22
|
| Rate for Payer: Galaxy Health WC |
$104.58
|
| Rate for Payer: Global Benefits Group Commercial |
$73.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.61
|
| Rate for Payer: Multiplan Commercial |
$92.28
|
| Rate for Payer: Networks By Design Commercial |
$79.98
|
| Rate for Payer: Prime Health Services Commercial |
$104.58
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
|
OP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$101.03 |
| Rate for Payer: Adventist Health Commercial |
$22.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$95.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.30
|
| Rate for Payer: Blue Shield of California Commercial |
$71.17
|
| Rate for Payer: Blue Shield of California EPN |
$44.79
|
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Central Health Plan Commercial |
$89.80
|
| Rate for Payer: Cigna of CA HMO |
$71.84
|
| Rate for Payer: Cigna of CA PPO |
$83.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$95.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$95.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$95.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: EPIC Health Plan Senior |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$78.58
|
| Rate for Payer: Multiplan Commercial |
$84.19
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
| Rate for Payer: Riverside University Health System MISP |
$44.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.12
|
| Rate for Payer: United Healthcare All Other HMO |
$56.12
|
| Rate for Payer: United Healthcare HMO Rider |
$56.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$95.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$95.41
|
| Rate for Payer: Vantage Medical Group Senior |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
|
IP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$101.03 |
| Rate for Payer: Adventist Health Commercial |
$22.45
|
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Central Health Plan Commercial |
$89.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: EPIC Health Plan Senior |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.45
|
| Rate for Payer: Multiplan Commercial |
$84.19
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
|
OP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Adventist Health Commercial |
$23.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$89.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.27
|
| Rate for Payer: Blue Shield of California Commercial |
$75.50
|
| Rate for Payer: Blue Shield of California EPN |
$47.52
|
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Central Health Plan Commercial |
$95.27
|
| Rate for Payer: Cigna of CA HMO |
$76.22
|
| Rate for Payer: Cigna of CA PPO |
$88.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$101.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$83.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: EPIC Health Plan Senior |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$75.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.36
|
| Rate for Payer: Multiplan Commercial |
$89.32
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
| Rate for Payer: Riverside University Health System MISP |
$47.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.55
|
| Rate for Payer: United Healthcare All Other HMO |
$59.55
|
| Rate for Payer: United Healthcare HMO Rider |
$59.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.23
|
| Rate for Payer: Vantage Medical Group Senior |
$101.23
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
|
IP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Adventist Health Commercial |
$23.82
|
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Central Health Plan Commercial |
$95.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$83.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: EPIC Health Plan Senior |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$75.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.82
|
| Rate for Payer: Multiplan Commercial |
$89.32
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
|
OP
|
$24.52
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Adventist Health Commercial |
$4.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.26
|
| Rate for Payer: Blue Shield of California Commercial |
$15.55
|
| Rate for Payer: Blue Shield of California EPN |
$9.78
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Central Health Plan Commercial |
$19.62
|
| Rate for Payer: Cigna of CA HMO |
$15.69
|
| Rate for Payer: Cigna of CA PPO |
$18.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: EPIC Health Plan Senior |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.16
|
| Rate for Payer: Multiplan Commercial |
$18.39
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
| Rate for Payer: Riverside University Health System MISP |
$9.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.26
|
| Rate for Payer: United Healthcare All Other HMO |
$12.26
|
| Rate for Payer: United Healthcare HMO Rider |
$12.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.84
|
| Rate for Payer: Vantage Medical Group Senior |
$20.84
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
|
IP
|
$24.52
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Adventist Health Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Central Health Plan Commercial |
$19.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: EPIC Health Plan Senior |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: Multiplan Commercial |
$18.39
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
|
OP
|
$120.38
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.08 |
| Max. Negotiated Rate |
$108.34 |
| Rate for Payer: Adventist Health Commercial |
$24.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.03
|
| Rate for Payer: Blue Shield of California Commercial |
$76.32
|
| Rate for Payer: Blue Shield of California EPN |
$48.03
|
| Rate for Payer: Cash Price |
$54.17
|
| Rate for Payer: Central Health Plan Commercial |
$96.30
|
| Rate for Payer: Cigna of CA HMO |
$77.04
|
| Rate for Payer: Cigna of CA PPO |
$89.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.15
|
| Rate for Payer: EPIC Health Plan Senior |
$48.15
|
| Rate for Payer: Galaxy Health WC |
$102.32
|
| Rate for Payer: Global Benefits Group Commercial |
$72.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$84.27
|
| Rate for Payer: Multiplan Commercial |
$90.28
|
| Rate for Payer: Networks By Design Commercial |
$78.25
|
| Rate for Payer: Prime Health Services Commercial |
$102.32
|
| Rate for Payer: Riverside University Health System MISP |
$48.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.19
|
| Rate for Payer: United Healthcare All Other HMO |
$60.19
|
| Rate for Payer: United Healthcare HMO Rider |
$60.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.32
|
| Rate for Payer: Vantage Medical Group Senior |
$102.32
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
|
IP
|
$120.38
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.08 |
| Max. Negotiated Rate |
$108.34 |
| Rate for Payer: Adventist Health Commercial |
$24.08
|
| Rate for Payer: Cash Price |
$54.17
|
| Rate for Payer: Central Health Plan Commercial |
$96.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.15
|
| Rate for Payer: EPIC Health Plan Senior |
$48.15
|
| Rate for Payer: Galaxy Health WC |
$102.32
|
| Rate for Payer: Global Benefits Group Commercial |
$72.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.08
|
| Rate for Payer: Multiplan Commercial |
$90.28
|
| Rate for Payer: Networks By Design Commercial |
$78.25
|
| Rate for Payer: Prime Health Services Commercial |
$102.32
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
|
IP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
|
OP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$19.45 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.49
|
| Rate for Payer: Blue Shield of California Commercial |
$8.16
|
| Rate for Payer: Blue Shield of California EPN |
$5.14
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.01
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Riverside University Health System MISP |
$5.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.43
|
| Rate for Payer: United Healthcare All Other HMO |
$6.43
|
| Rate for Payer: United Healthcare HMO Rider |
$6.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
|
OP
|
$21.16
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.45 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.31
|
| Rate for Payer: Blue Shield of California Commercial |
$13.42
|
| Rate for Payer: Blue Shield of California EPN |
$8.44
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: Cigna of CA HMO |
$13.54
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.81
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
| Rate for Payer: Riverside University Health System MISP |
$8.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.99
|
| Rate for Payer: Vantage Medical Group Senior |
$17.99
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
|
IP
|
$21.16
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
|
|
HC TRAY FOLEY INS W 30ML SYR PVP
|
Facility
|
OP
|
$15.17
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901607398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$30.86 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.82
|
| Rate for Payer: Blue Shield of California Commercial |
$9.62
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: Cigna of CA HMO |
$9.71
|
| Rate for Payer: Cigna of CA PPO |
$11.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.62
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
| Rate for Payer: Riverside University Health System MISP |
$6.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC TRAY FOLEY INS W 30ML SYR PVP
|
Facility
|
IP
|
$15.17
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901607398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
|
|
HC TRAY FOLEY URN MTR NO CATH
|
Facility
|
IP
|
$140.75
|
|
|
Service Code
|
CPT A4354
|
| Hospital Charge Code |
901698796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.15 |
| Max. Negotiated Rate |
$126.67 |
| Rate for Payer: Adventist Health Commercial |
$28.15
|
| Rate for Payer: Cash Price |
$63.34
|
| Rate for Payer: Central Health Plan Commercial |
$112.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$98.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.30
|
| Rate for Payer: EPIC Health Plan Senior |
$56.30
|
| Rate for Payer: Galaxy Health WC |
$119.64
|
| Rate for Payer: Global Benefits Group Commercial |
$84.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$83.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.15
|
| Rate for Payer: Multiplan Commercial |
$105.56
|
| Rate for Payer: Networks By Design Commercial |
$91.49
|
| Rate for Payer: Prime Health Services Commercial |
$119.64
|
|
|
HC TRAY FOLEY URN MTR NO CATH
|
Facility
|
OP
|
$140.75
|
|
|
Service Code
|
CPT A4354
|
| Hospital Charge Code |
901698796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.15 |
| Max. Negotiated Rate |
$126.67 |
| Rate for Payer: Adventist Health Commercial |
$28.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$119.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$77.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.87
|
| Rate for Payer: Blue Shield of California Commercial |
$89.24
|
| Rate for Payer: Blue Shield of California EPN |
$56.16
|
| Rate for Payer: Cash Price |
$63.34
|
| Rate for Payer: Cash Price |
$63.34
|
| Rate for Payer: Central Health Plan Commercial |
$112.60
|
| Rate for Payer: Cigna of CA HMO |
$90.08
|
| Rate for Payer: Cigna of CA PPO |
$104.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$119.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$119.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$119.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$98.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.30
|
| Rate for Payer: EPIC Health Plan Senior |
$56.30
|
| Rate for Payer: Galaxy Health WC |
$119.64
|
| Rate for Payer: Global Benefits Group Commercial |
$84.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$51.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$83.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$98.53
|
| Rate for Payer: Multiplan Commercial |
$105.56
|
| Rate for Payer: Networks By Design Commercial |
$91.49
|
| Rate for Payer: Prime Health Services Commercial |
$119.64
|
| Rate for Payer: Riverside University Health System MISP |
$56.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$84.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$84.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$70.38
|
| Rate for Payer: United Healthcare All Other HMO |
$70.38
|
| Rate for Payer: United Healthcare HMO Rider |
$70.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$70.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$119.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$119.64
|
| Rate for Payer: Vantage Medical Group Senior |
$119.64
|
|
|
HC TRAY LEADER FLEX INSERTION
|
Facility
|
IP
|
$4.42
|
|
| Hospital Charge Code |
901698221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Adventist Health Commercial |
$0.88
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.76
|
| Rate for Payer: Global Benefits Group Commercial |
$2.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.88
|
| Rate for Payer: Multiplan Commercial |
$3.31
|
| Rate for Payer: Networks By Design Commercial |
$2.87
|
| Rate for Payer: Prime Health Services Commercial |
$3.76
|
|
|
HC TRAY LEADER FLEX INSERTION
|
Facility
|
OP
|
$4.42
|
|
| Hospital Charge Code |
901698221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Adventist Health Commercial |
$0.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.57
|
| Rate for Payer: Blue Shield of California Commercial |
$2.80
|
| Rate for Payer: Blue Shield of California EPN |
$1.76
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: Cigna of CA HMO |
$2.83
|
| Rate for Payer: Cigna of CA PPO |
$3.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.76
|
| Rate for Payer: Global Benefits Group Commercial |
$2.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.09
|
| Rate for Payer: Multiplan Commercial |
$3.31
|
| Rate for Payer: Networks By Design Commercial |
$2.87
|
| Rate for Payer: Prime Health Services Commercial |
$3.76
|
| Rate for Payer: Riverside University Health System MISP |
$1.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.21
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare HMO Rider |
$2.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.76
|
| Rate for Payer: Vantage Medical Group Senior |
$3.76
|
|
