|
HC TRAY CATH 16FR URN MTR 2WAY
|
Facility
|
IP
|
$125.86
|
|
|
Service Code
|
CPT A4315
|
| Hospital Charge Code |
901698793
|
|
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 |
$69.22
|
| Rate for Payer: Central Health Plan Commercial |
$100.69
|
| 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 Permanente of CA Commercial/Self Funded |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.91
|
| 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 16FR URN MTR 2WAY
|
Facility
|
OP
|
$125.86
|
|
|
Service Code
|
CPT A4315
|
| Hospital Charge Code |
901698793
|
|
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: Aetna of CA HMO/PPO |
$76.43
|
| 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 |
$73.92
|
| Rate for Payer: Blue Shield of California Commercial |
$76.90
|
| Rate for Payer: Blue Shield of California EPN |
$50.22
|
| Rate for Payer: Cash Price |
$69.22
|
| 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: 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: InnovAge PACE Commercial |
$62.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.10
|
| Rate for Payer: Molina Healthcare of CA 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 18FR DRAIN BAG 2WAY
|
Facility
|
OP
|
$105.56
|
|
|
Service Code
|
CPT A4315
|
| Hospital Charge Code |
901698791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.11 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Adventist Health Commercial |
$21.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$79.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.00
|
| Rate for Payer: Blue Shield of California Commercial |
$64.50
|
| Rate for Payer: Blue Shield of California EPN |
$42.12
|
| Rate for Payer: Cash Price |
$58.06
|
| Rate for Payer: Central Health Plan Commercial |
$84.45
|
| Rate for Payer: Cigna of CA HMO |
$67.56
|
| Rate for Payer: Cigna of CA PPO |
$78.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.22
|
| Rate for Payer: EPIC Health Plan Senior |
$42.22
|
| Rate for Payer: Galaxy Health WC |
$89.73
|
| Rate for Payer: Global Benefits Group Commercial |
$63.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.00
|
| Rate for Payer: InnovAge PACE Commercial |
$52.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.89
|
| Rate for Payer: Multiplan Commercial |
$79.17
|
| Rate for Payer: Networks By Design Commercial |
$68.61
|
| Rate for Payer: Prime Health Services Commercial |
$89.73
|
| Rate for Payer: Riverside University Health System MISP |
$42.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.78
|
| Rate for Payer: United Healthcare All Other HMO |
$52.78
|
| Rate for Payer: United Healthcare HMO Rider |
$52.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.73
|
| Rate for Payer: Vantage Medical Group Senior |
$89.73
|
|
|
HC TRAY CATH 18FR DRAIN BAG 2WAY
|
Facility
|
IP
|
$105.56
|
|
|
Service Code
|
CPT A4315
|
| Hospital Charge Code |
901698791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.11 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Adventist Health Commercial |
$21.11
|
| Rate for Payer: Cash Price |
$58.06
|
| Rate for Payer: Central Health Plan Commercial |
$84.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.22
|
| Rate for Payer: EPIC Health Plan Senior |
$42.22
|
| Rate for Payer: Galaxy Health WC |
$89.73
|
| Rate for Payer: Global Benefits Group Commercial |
$63.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.11
|
| Rate for Payer: Multiplan Commercial |
$79.17
|
| Rate for Payer: Networks By Design Commercial |
$68.61
|
| Rate for Payer: Prime Health Services Commercial |
$89.73
|
|
|
HC TRAY CATH COUDE URN MTR 16FR
|
Facility
|
OP
|
$153.37
|
|
| Hospital Charge Code |
901608086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$138.03 |
| Rate for Payer: Adventist Health Commercial |
$30.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$130.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.07
|
| Rate for Payer: Blue Shield of California Commercial |
$93.71
|
| Rate for Payer: Blue Shield of California EPN |
$61.19
|
| Rate for Payer: Cash Price |
$84.35
|
| Rate for Payer: Central Health Plan Commercial |
$122.70
|
| Rate for Payer: Cigna of CA HMO |
$98.16
|
| Rate for Payer: Cigna of CA PPO |
$113.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$130.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.35
|
| Rate for Payer: EPIC Health Plan Senior |
$61.35
|
| Rate for Payer: Galaxy Health WC |
$130.36
|
| Rate for Payer: Global Benefits Group Commercial |
$92.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.03
|
| Rate for Payer: InnovAge PACE Commercial |
$76.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$107.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107.36
|
| Rate for Payer: Multiplan Commercial |
$115.03
|
| Rate for Payer: Networks By Design Commercial |
$99.69
|
| Rate for Payer: Prime Health Services Commercial |
$130.36
|
| Rate for Payer: Riverside University Health System MISP |
$61.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.69
|
| Rate for Payer: United Healthcare All Other HMO |
$76.69
|
| Rate for Payer: United Healthcare HMO Rider |
$76.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$130.36
|
| Rate for Payer: Vantage Medical Group Senior |
$130.36
|
|
|
HC TRAY CATH COUDE URN MTR 16FR
|
Facility
|
IP
|
$153.37
|
|
| Hospital Charge Code |
901608086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$138.03 |
| Rate for Payer: Adventist Health Commercial |
$30.67
|
| Rate for Payer: Cash Price |
$84.35
|
| Rate for Payer: Central Health Plan Commercial |
$122.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.35
|
| Rate for Payer: EPIC Health Plan Senior |
$61.35
|
| Rate for Payer: Galaxy Health WC |
$130.36
|
| Rate for Payer: Global Benefits Group Commercial |
$92.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.67
|
| Rate for Payer: Multiplan Commercial |
$115.03
|
| Rate for Payer: Networks By Design Commercial |
$99.69
|
| Rate for Payer: Prime Health Services Commercial |
$130.36
|
|
|
HC TRAY CATH PICC POWER 3FR SL
|
Facility
|
OP
|
$906.38
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.28 |
| Max. Negotiated Rate |
$815.74 |
| Rate for Payer: Adventist Health Commercial |
$181.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$770.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$498.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$679.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$413.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$501.86
|
| Rate for Payer: Blue Shield of California Commercial |
$700.63
|
| Rate for Payer: Blue Shield of California EPN |
$456.82
|
| Rate for Payer: Cash Price |
$498.51
|
| Rate for Payer: Central Health Plan Commercial |
$725.10
|
| Rate for Payer: Cigna of CA HMO |
$634.47
|
| Rate for Payer: Cigna of CA PPO |
$634.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$770.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$770.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$770.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$362.55
|
| Rate for Payer: EPIC Health Plan Senior |
$362.55
|
| Rate for Payer: Galaxy Health WC |
$770.42
|
| Rate for Payer: Global Benefits Group Commercial |
$543.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$815.74
|
| Rate for Payer: InnovAge PACE Commercial |
$453.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$604.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$345.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$561.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$634.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$634.47
|
| Rate for Payer: Multiplan Commercial |
$679.78
|
| Rate for Payer: Networks By Design Commercial |
$453.19
|
| Rate for Payer: Prime Health Services Commercial |
$770.42
|
| Rate for Payer: Riverside University Health System MISP |
$362.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$543.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$543.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.16
|
| Rate for Payer: United Healthcare All Other HMO |
$331.10
|
| Rate for Payer: United Healthcare HMO Rider |
$323.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$770.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$770.42
|
| Rate for Payer: Vantage Medical Group Senior |
$770.42
|
|
|
HC TRAY CATH PICC POWER 3FR SL
|
Facility
|
IP
|
$906.38
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.28 |
| Max. Negotiated Rate |
$815.74 |
| Rate for Payer: Adventist Health Commercial |
$181.28
|
| Rate for Payer: Blue Shield of California Commercial |
$700.63
|
| Rate for Payer: Blue Shield of California EPN |
$456.82
|
| Rate for Payer: Cash Price |
$498.51
|
| Rate for Payer: Central Health Plan Commercial |
$725.10
|
| Rate for Payer: Cigna of CA HMO |
$634.47
|
| Rate for Payer: Cigna of CA PPO |
$634.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$362.55
|
| Rate for Payer: EPIC Health Plan Senior |
$362.55
|
| Rate for Payer: Galaxy Health WC |
$770.42
|
| Rate for Payer: Global Benefits Group Commercial |
$543.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$815.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$604.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$345.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$561.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.28
|
| Rate for Payer: Multiplan Commercial |
$679.78
|
| Rate for Payer: Networks By Design Commercial |
$453.19
|
| Rate for Payer: Prime Health Services Commercial |
$770.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.16
|
| Rate for Payer: United Healthcare All Other HMO |
$331.10
|
| Rate for Payer: United Healthcare HMO Rider |
$323.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.84
|
|
|
HC TRAY CATH PIGTAIL FUHRMAN 8.5FR
|
Facility
|
IP
|
$823.54
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.71 |
| Max. Negotiated Rate |
$741.19 |
| Rate for Payer: Adventist Health Commercial |
$164.71
|
| Rate for Payer: Cash Price |
$452.95
|
| Rate for Payer: Central Health Plan Commercial |
$658.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$329.42
|
| Rate for Payer: EPIC Health Plan Senior |
$329.42
|
| Rate for Payer: Galaxy Health WC |
$700.01
|
| Rate for Payer: Global Benefits Group Commercial |
$494.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$741.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$549.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$509.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.71
|
| Rate for Payer: Multiplan Commercial |
$617.65
|
| Rate for Payer: Networks By Design Commercial |
$535.30
|
| Rate for Payer: Prime Health Services Commercial |
$700.01
|
|
|
HC TRAY CATH PIGTAIL FUHRMAN 8.5FR
|
Facility
|
OP
|
$823.54
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.71 |
| Max. Negotiated Rate |
$741.19 |
| Rate for Payer: Adventist Health Commercial |
$164.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$500.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$700.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$452.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$617.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$398.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$483.67
|
| Rate for Payer: Blue Shield of California Commercial |
$503.18
|
| Rate for Payer: Blue Shield of California EPN |
$328.59
|
| Rate for Payer: Cash Price |
$452.95
|
| Rate for Payer: Central Health Plan Commercial |
$658.83
|
| Rate for Payer: Cigna of CA HMO |
$527.07
|
| Rate for Payer: Cigna of CA PPO |
$609.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$700.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$700.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$700.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$329.42
|
| Rate for Payer: EPIC Health Plan Senior |
$329.42
|
| Rate for Payer: Galaxy Health WC |
$700.01
|
| Rate for Payer: Global Benefits Group Commercial |
$494.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$741.19
|
| Rate for Payer: InnovAge PACE Commercial |
$411.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$549.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$509.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$576.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$576.48
|
| Rate for Payer: Multiplan Commercial |
$617.65
|
| Rate for Payer: Networks By Design Commercial |
$535.30
|
| Rate for Payer: Prime Health Services Commercial |
$700.01
|
| Rate for Payer: Riverside University Health System MISP |
$329.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$494.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$494.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$411.77
|
| Rate for Payer: United Healthcare All Other HMO |
$411.77
|
| Rate for Payer: United Healthcare HMO Rider |
$411.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$411.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$700.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$700.01
|
| Rate for Payer: Vantage Medical Group Senior |
$700.01
|
|
|
HC TRAY CATH PIGTAIL WAYNE 14FR
|
Facility
|
IP
|
$1,175.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901607301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.18 |
| Max. Negotiated Rate |
$1,058.31 |
| Rate for Payer: Adventist Health Commercial |
$235.18
|
| Rate for Payer: Blue Shield of California Commercial |
$908.97
|
| Rate for Payer: Blue Shield of California EPN |
$592.65
|
| Rate for Payer: Cash Price |
$646.75
|
| Rate for Payer: Central Health Plan Commercial |
$940.72
|
| Rate for Payer: Cigna of CA HMO |
$823.13
|
| Rate for Payer: Cigna of CA PPO |
$823.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.36
|
| Rate for Payer: EPIC Health Plan Senior |
$470.36
|
| Rate for Payer: Galaxy Health WC |
$999.51
|
| Rate for Payer: Global Benefits Group Commercial |
$705.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,058.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$784.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$727.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.18
|
| Rate for Payer: Multiplan Commercial |
$881.92
|
| Rate for Payer: Networks By Design Commercial |
$587.95
|
| Rate for Payer: Prime Health Services Commercial |
$999.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$441.32
|
| Rate for Payer: United Healthcare All Other HMO |
$429.56
|
| Rate for Payer: United Healthcare HMO Rider |
$420.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$385.11
|
|
|
HC TRAY CATH PIGTAIL WAYNE 14FR
|
Facility
|
OP
|
$1,175.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901607301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.18 |
| Max. Negotiated Rate |
$1,058.31 |
| Rate for Payer: Adventist Health Commercial |
$235.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$999.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$646.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$881.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$536.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$651.10
|
| Rate for Payer: Blue Shield of California Commercial |
$908.97
|
| Rate for Payer: Blue Shield of California EPN |
$592.65
|
| Rate for Payer: Cash Price |
$646.75
|
| Rate for Payer: Central Health Plan Commercial |
$940.72
|
| Rate for Payer: Cigna of CA HMO |
$823.13
|
| Rate for Payer: Cigna of CA PPO |
$823.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$999.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$999.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$999.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.36
|
| Rate for Payer: EPIC Health Plan Senior |
$470.36
|
| Rate for Payer: Galaxy Health WC |
$999.51
|
| Rate for Payer: Global Benefits Group Commercial |
$705.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,058.31
|
| Rate for Payer: InnovAge PACE Commercial |
$587.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$784.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$727.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$823.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$823.13
|
| Rate for Payer: Multiplan Commercial |
$881.92
|
| Rate for Payer: Networks By Design Commercial |
$587.95
|
| Rate for Payer: Prime Health Services Commercial |
$999.51
|
| Rate for Payer: Riverside University Health System MISP |
$470.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$705.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$705.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$441.32
|
| Rate for Payer: United Healthcare All Other HMO |
$429.56
|
| Rate for Payer: United Healthcare HMO Rider |
$420.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$385.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$999.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$999.51
|
| Rate for Payer: Vantage Medical Group Senior |
$999.51
|
|
|
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 |
$39.17 |
| Max. Negotiated Rate |
$176.27 |
| Rate for Payer: Adventist Health Commercial |
$39.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.95
|
| 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 |
$115.03
|
| Rate for Payer: Blue Shield of California Commercial |
$119.67
|
| Rate for Payer: Blue Shield of California EPN |
$78.15
|
| Rate for Payer: Cash Price |
$107.72
|
| 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: 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: InnovAge PACE Commercial |
$97.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.10
|
| Rate for Payer: Molina Healthcare of CA 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 16FR URN MTR
|
Facility
|
IP
|
$195.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.17 |
| Max. Negotiated Rate |
$176.27 |
| Rate for Payer: Adventist Health Commercial |
$39.17
|
| Rate for Payer: Cash Price |
$107.72
|
| Rate for Payer: Central Health Plan Commercial |
$156.69
|
| 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 Permanente of CA Commercial/Self Funded |
$130.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.17
|
| 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
|
|
|
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 |
$69.22
|
| Rate for Payer: Central Health Plan Commercial |
$100.69
|
| 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 Permanente of CA Commercial/Self Funded |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.91
|
| 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 |
$25.17 |
| Max. Negotiated Rate |
$113.27 |
| Rate for Payer: Adventist Health Commercial |
$25.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$76.43
|
| 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 |
$73.92
|
| Rate for Payer: Blue Shield of California Commercial |
$76.90
|
| Rate for Payer: Blue Shield of California EPN |
$50.22
|
| Rate for Payer: Cash Price |
$69.22
|
| 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: 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: InnovAge PACE Commercial |
$62.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.10
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$54.92
|
| Rate for Payer: Central Health Plan Commercial |
$79.89
|
| 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 Permanente of CA Commercial/Self Funded |
$66.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.81
|
| 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 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 |
$58.65
|
| Rate for Payer: Blue Shield of California Commercial |
$61.01
|
| Rate for Payer: Blue Shield of California EPN |
$39.84
|
| Rate for Payer: Cash Price |
$54.92
|
| 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: 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: InnovAge PACE Commercial |
$49.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.90
|
| Rate for Payer: Molina Healthcare of CA 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 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 |
$67.67
|
| Rate for Payer: Central Health Plan Commercial |
$98.43
|
| 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 Permanente of CA Commercial/Self Funded |
$82.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.16
|
| 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 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 |
$72.26
|
| Rate for Payer: Blue Shield of California Commercial |
$75.18
|
| Rate for Payer: Blue Shield of California EPN |
$49.09
|
| Rate for Payer: Cash Price |
$67.67
|
| 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: 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: InnovAge PACE Commercial |
$61.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.13
|
| Rate for Payer: Molina Healthcare of CA 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 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 |
$65.92
|
| Rate for Payer: Blue Shield of California Commercial |
$68.58
|
| Rate for Payer: Blue Shield of California EPN |
$44.79
|
| Rate for Payer: Cash Price |
$61.74
|
| 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: 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: InnovAge PACE Commercial |
$56.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.58
|
| Rate for Payer: Molina Healthcare of CA 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 |
$61.74
|
| Rate for Payer: Central Health Plan Commercial |
$89.80
|
| 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 Permanente of CA Commercial/Self Funded |
$74.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.48
|
| 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 |
$69.94
|
| Rate for Payer: Blue Shield of California Commercial |
$72.76
|
| Rate for Payer: Blue Shield of California EPN |
$47.52
|
| Rate for Payer: Cash Price |
$65.50
|
| 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: 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: InnovAge PACE Commercial |
$59.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83.36
|
| Rate for Payer: Molina Healthcare of CA 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 |
$65.50
|
| Rate for Payer: Central Health Plan Commercial |
$95.27
|
| 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 Permanente of CA Commercial/Self Funded |
$79.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.72
|
| 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 |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14.98
|
| Rate for Payer: Blue Shield of California EPN |
$9.78
|
| Rate for Payer: Cash Price |
$13.49
|
| 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: 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: InnovAge PACE Commercial |
$12.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.16
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
