|
HC ARTER, EA ADDL, 2ND/3RD ORD
|
Facility
|
IP
|
$758.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
909081322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$151.60 |
| Max. Negotiated Rate |
$682.20 |
| Rate for Payer: Adventist Health Commercial |
$151.60
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Central Health Plan Commercial |
$606.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.20
|
| Rate for Payer: EPIC Health Plan Senior |
$303.20
|
| Rate for Payer: Galaxy Health WC |
$644.30
|
| Rate for Payer: Global Benefits Group Commercial |
$454.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$682.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$505.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$469.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.60
|
| Rate for Payer: Multiplan Commercial |
$568.50
|
| Rate for Payer: Networks By Design Commercial |
$492.70
|
| Rate for Payer: Prime Health Services Commercial |
$644.30
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
OP
|
$1,984.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$309.93 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$396.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,091.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,488.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$960.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,165.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,091.20
|
| Rate for Payer: Cash Price |
$1,091.20
|
| Rate for Payer: Cash Price |
$1,091.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,587.20
|
| Rate for Payer: Cigna of CA HMO |
$1,269.76
|
| Rate for Payer: Cigna of CA PPO |
$1,468.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,686.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,686.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.60
|
| Rate for Payer: EPIC Health Plan Senior |
$793.60
|
| Rate for Payer: Galaxy Health WC |
$1,686.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,190.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,785.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$309.93
|
| Rate for Payer: InnovAge PACE Commercial |
$992.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,323.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,228.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,388.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,388.80
|
| Rate for Payer: Multiplan Commercial |
$1,488.00
|
| Rate for Payer: Networks By Design Commercial |
$1,289.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,686.40
|
| Rate for Payer: Riverside University Health System MISP |
$793.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,190.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,686.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,686.40
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
IP
|
$1,984.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.80 |
| Max. Negotiated Rate |
$1,785.60 |
| Rate for Payer: Adventist Health Commercial |
$396.80
|
| Rate for Payer: Cash Price |
$1,091.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,587.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.60
|
| Rate for Payer: EPIC Health Plan Senior |
$793.60
|
| Rate for Payer: Galaxy Health WC |
$1,686.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,190.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,785.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,323.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$755.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,228.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.80
|
| Rate for Payer: Multiplan Commercial |
$1,488.00
|
| Rate for Payer: Networks By Design Commercial |
$1,289.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,686.40
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
OP
|
$2,334.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
906820176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$309.93 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$466.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,983.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,750.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,130.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,370.76
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,283.70
|
| Rate for Payer: Cash Price |
$1,283.70
|
| Rate for Payer: Cash Price |
$1,283.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,867.20
|
| Rate for Payer: Cigna of CA HMO |
$1,493.76
|
| Rate for Payer: Cigna of CA PPO |
$1,727.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,983.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,983.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,983.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$933.60
|
| Rate for Payer: Galaxy Health WC |
$1,983.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,100.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$309.93
|
| Rate for Payer: InnovAge PACE Commercial |
$1,167.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,444.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,633.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,633.80
|
| Rate for Payer: Multiplan Commercial |
$1,750.50
|
| Rate for Payer: Networks By Design Commercial |
$1,517.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,983.90
|
| Rate for Payer: Riverside University Health System MISP |
$933.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,400.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,983.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,983.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,983.90
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
IP
|
$2,334.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
906820176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$466.80 |
| Max. Negotiated Rate |
$2,100.60 |
| Rate for Payer: Adventist Health Commercial |
$466.80
|
| Rate for Payer: Cash Price |
$1,283.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,867.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$933.60
|
| Rate for Payer: EPIC Health Plan Senior |
$933.60
|
| Rate for Payer: Galaxy Health WC |
$1,983.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,400.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$889.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,444.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.80
|
| Rate for Payer: Multiplan Commercial |
$1,750.50
|
| Rate for Payer: Networks By Design Commercial |
$1,517.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,983.90
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
OP
|
$1,183.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
906820177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$236.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,005.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$650.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$887.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$572.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$694.78
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$650.65
|
| Rate for Payer: Cash Price |
$650.65
|
| Rate for Payer: Cash Price |
$650.65
|
| Rate for Payer: Central Health Plan Commercial |
$946.40
|
| Rate for Payer: Cigna of CA HMO |
$757.12
|
| Rate for Payer: Cigna of CA PPO |
$875.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,005.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,005.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,005.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$473.20
|
| Rate for Payer: EPIC Health Plan Senior |
$473.20
|
| Rate for Payer: Galaxy Health WC |
$1,005.55
|
| Rate for Payer: Global Benefits Group Commercial |
$709.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,064.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$75.56
|
| Rate for Payer: InnovAge PACE Commercial |
$591.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$732.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$828.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$828.10
|
| Rate for Payer: Multiplan Commercial |
$887.25
|
| Rate for Payer: Networks By Design Commercial |
$768.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,005.55
|
| Rate for Payer: Riverside University Health System MISP |
$473.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$709.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,005.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,005.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,005.55
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$905.40 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$671.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$383.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$622.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
IP
|
$1,183.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
906820177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$236.60 |
| Max. Negotiated Rate |
$1,064.70 |
| Rate for Payer: Adventist Health Commercial |
$236.60
|
| Rate for Payer: Cash Price |
$650.65
|
| Rate for Payer: Central Health Plan Commercial |
$946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$473.20
|
| Rate for Payer: EPIC Health Plan Senior |
$473.20
|
| Rate for Payer: Galaxy Health WC |
$1,005.55
|
| Rate for Payer: Global Benefits Group Commercial |
$709.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,064.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$450.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$732.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.60
|
| Rate for Payer: Multiplan Commercial |
$887.25
|
| Rate for Payer: Networks By Design Commercial |
$768.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,005.55
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$855.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$553.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$754.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$487.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$590.82
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Cash Price |
$553.30
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$855.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$855.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$75.56
|
| Rate for Payer: InnovAge PACE Commercial |
$503.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$671.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$622.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$704.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$704.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Riverside University Health System MISP |
$402.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$855.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.10
|
| Rate for Payer: Vantage Medical Group Senior |
$855.10
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$918.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$594.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$810.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$523.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$634.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Central Health Plan Commercial |
$864.80
|
| Rate for Payer: Cigna of CA HMO |
$691.84
|
| Rate for Payer: Cigna of CA PPO |
$799.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$918.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$918.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$918.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$432.40
|
| Rate for Payer: EPIC Health Plan Senior |
$432.40
|
| Rate for Payer: Galaxy Health WC |
$918.85
|
| Rate for Payer: Global Benefits Group Commercial |
$648.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$972.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$452.08
|
| Rate for Payer: InnovAge PACE Commercial |
$540.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$721.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$756.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$756.70
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
| Rate for Payer: Networks By Design Commercial |
$702.65
|
| Rate for Payer: Prime Health Services Commercial |
$918.85
|
| Rate for Payer: Riverside University Health System MISP |
$432.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$648.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$918.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$918.85
|
| Rate for Payer: Vantage Medical Group Senior |
$918.85
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.20 |
| Max. Negotiated Rate |
$972.90 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Cash Price |
$594.55
|
| Rate for Payer: Central Health Plan Commercial |
$864.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$432.40
|
| Rate for Payer: EPIC Health Plan Senior |
$432.40
|
| Rate for Payer: Galaxy Health WC |
$918.85
|
| Rate for Payer: Global Benefits Group Commercial |
$648.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$972.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$721.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$411.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$669.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.20
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
| Rate for Payer: Networks By Design Commercial |
$702.65
|
| Rate for Payer: Prime Health Services Commercial |
$918.85
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$1,272.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
906820178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.40 |
| Max. Negotiated Rate |
$1,144.80 |
| Rate for Payer: Adventist Health Commercial |
$254.40
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,017.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$508.80
|
| Rate for Payer: EPIC Health Plan Senior |
$508.80
|
| Rate for Payer: Galaxy Health WC |
$1,081.20
|
| Rate for Payer: Global Benefits Group Commercial |
$763.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,144.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$848.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$484.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$787.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.40
|
| Rate for Payer: Multiplan Commercial |
$954.00
|
| Rate for Payer: Networks By Design Commercial |
$826.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,081.20
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$1,272.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
906820178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.40 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$254.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,081.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$699.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$954.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$615.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.05
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,017.60
|
| Rate for Payer: Cigna of CA HMO |
$814.08
|
| Rate for Payer: Cigna of CA PPO |
$941.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,081.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,081.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,081.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$508.80
|
| Rate for Payer: EPIC Health Plan Senior |
$508.80
|
| Rate for Payer: Galaxy Health WC |
$1,081.20
|
| Rate for Payer: Global Benefits Group Commercial |
$763.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,144.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$452.08
|
| Rate for Payer: InnovAge PACE Commercial |
$636.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$848.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$787.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$890.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$890.40
|
| Rate for Payer: Multiplan Commercial |
$954.00
|
| Rate for Payer: Networks By Design Commercial |
$826.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,081.20
|
| Rate for Payer: Riverside University Health System MISP |
$508.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$763.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,081.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,081.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,081.20
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
IP
|
$458.95
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.79 |
| Max. Negotiated Rate |
$413.06 |
| Rate for Payer: Adventist Health Commercial |
$91.79
|
| Rate for Payer: Cash Price |
$252.42
|
| Rate for Payer: Central Health Plan Commercial |
$367.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.58
|
| Rate for Payer: EPIC Health Plan Senior |
$183.58
|
| Rate for Payer: Galaxy Health WC |
$390.11
|
| Rate for Payer: Global Benefits Group Commercial |
$275.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.79
|
| Rate for Payer: Multiplan Commercial |
$344.21
|
| Rate for Payer: Networks By Design Commercial |
$298.32
|
| Rate for Payer: Prime Health Services Commercial |
$390.11
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
OP
|
$458.95
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.79 |
| Max. Negotiated Rate |
$413.06 |
| Rate for Payer: Adventist Health Commercial |
$91.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$278.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$344.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$222.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$269.54
|
| Rate for Payer: Blue Shield of California Commercial |
$280.42
|
| Rate for Payer: Blue Shield of California EPN |
$183.12
|
| Rate for Payer: Cash Price |
$252.42
|
| Rate for Payer: Central Health Plan Commercial |
$367.16
|
| Rate for Payer: Cigna of CA HMO |
$293.73
|
| Rate for Payer: Cigna of CA PPO |
$339.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$390.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.58
|
| Rate for Payer: EPIC Health Plan Senior |
$183.58
|
| Rate for Payer: Galaxy Health WC |
$390.11
|
| Rate for Payer: Global Benefits Group Commercial |
$275.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.06
|
| Rate for Payer: InnovAge PACE Commercial |
$229.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$321.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$321.26
|
| Rate for Payer: Multiplan Commercial |
$344.21
|
| Rate for Payer: Networks By Design Commercial |
$298.32
|
| Rate for Payer: Prime Health Services Commercial |
$390.11
|
| Rate for Payer: Riverside University Health System MISP |
$183.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.47
|
| Rate for Payer: United Healthcare All Other HMO |
$229.47
|
| Rate for Payer: United Healthcare HMO Rider |
$229.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.11
|
| Rate for Payer: Vantage Medical Group Senior |
$390.11
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
OP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$100.51 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.59
|
| Rate for Payer: Blue Shield of California Commercial |
$68.24
|
| Rate for Payer: Blue Shield of California EPN |
$44.56
|
| Rate for Payer: Cash Price |
$61.42
|
| Rate for Payer: Central Health Plan Commercial |
$89.34
|
| Rate for Payer: Cigna of CA HMO |
$71.48
|
| Rate for Payer: Cigna of CA PPO |
$82.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.51
|
| Rate for Payer: InnovAge PACE Commercial |
$55.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.18
|
| Rate for Payer: Multiplan Commercial |
$83.76
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
| Rate for Payer: Riverside University Health System MISP |
$44.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.84
|
| Rate for Payer: United Healthcare All Other HMO |
$55.84
|
| Rate for Payer: United Healthcare HMO Rider |
$55.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.93
|
| Rate for Payer: Vantage Medical Group Senior |
$94.93
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
IP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$100.51 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Cash Price |
$61.42
|
| Rate for Payer: Central Health Plan Commercial |
$89.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Multiplan Commercial |
$83.76
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
906820099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.40 |
| Max. Negotiated Rate |
$924.30 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: EPIC Health Plan Senior |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$635.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
906820099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$205.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$872.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$564.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$770.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$497.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$603.16
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Cash Price |
$564.85
|
| Rate for Payer: Central Health Plan Commercial |
$821.60
|
| Rate for Payer: Cigna of CA HMO |
$657.28
|
| Rate for Payer: Cigna of CA PPO |
$759.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$872.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$872.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$872.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: EPIC Health Plan Senior |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$924.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.36
|
| Rate for Payer: InnovAge PACE Commercial |
$513.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$635.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$718.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$718.90
|
| Rate for Payer: Multiplan Commercial |
$770.25
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
| Rate for Payer: Riverside University Health System MISP |
$410.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$616.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$872.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$872.95
|
| Rate for Payer: Vantage Medical Group Senior |
$872.95
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$436.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.10
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Riverside University Health System MISP |
$349.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$436.50
|
| Rate for Payer: United Healthcare All Other HMO |
$436.50
|
| Rate for Payer: United Healthcare HMO Rider |
$436.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$436.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.05
|
| Rate for Payer: Vantage Medical Group Senior |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$422.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$512.71
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Cash Price |
$480.15
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.36
|
| Rate for Payer: InnovAge PACE Commercial |
$436.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.10
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Riverside University Health System MISP |
$349.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.05
|
| Rate for Payer: Vantage Medical Group Senior |
$742.05
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
OP
|
$11,579.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$222.48 |
| Max. Negotiated Rate |
$11,264.31 |
| Rate for Payer: Adventist Health Commercial |
$2,315.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,031.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$532.28
|
| Rate for Payer: Blue Shield of California Commercial |
$7,028.45
|
| Rate for Payer: Blue Shield of California EPN |
$4,596.86
|
| Rate for Payer: Cash Price |
$6,368.45
|
| Rate for Payer: Cash Price |
$6,368.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,263.20
|
| Rate for Payer: Cigna of CA HMO |
$7,410.56
|
| Rate for Payer: Cigna of CA PPO |
$8,568.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$9,842.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,947.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,421.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,723.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,315.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$8,684.25
|
| Rate for Payer: Networks By Design Commercial |
$7,526.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Prime Health Services Commercial |
$9,842.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,947.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,947.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
IP
|
$13,622.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
906820193
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,724.40 |
| Max. Negotiated Rate |
$12,259.80 |
| Rate for Payer: Adventist Health Commercial |
$2,724.40
|
| Rate for Payer: Cash Price |
$7,492.10
|
| Rate for Payer: Central Health Plan Commercial |
$10,897.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,448.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,448.80
|
| Rate for Payer: Galaxy Health WC |
$11,578.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,173.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,259.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,085.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,189.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,432.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,724.40
|
| Rate for Payer: Multiplan Commercial |
$10,216.50
|
| Rate for Payer: Networks By Design Commercial |
$8,854.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,578.70
|
|
