|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
OP
|
$187.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$37.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$159.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$103.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$90.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.13
|
| Rate for Payer: Blue Shield of California Commercial |
$118.94
|
| Rate for Payer: Blue Shield of California EPN |
$74.85
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Central Health Plan Commercial |
$150.08
|
| Rate for Payer: Cigna of CA HMO |
$120.06
|
| Rate for Payer: Cigna of CA PPO |
$138.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$159.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$159.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$159.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$131.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.04
|
| Rate for Payer: EPIC Health Plan Senior |
$75.04
|
| Rate for Payer: Galaxy Health WC |
$159.46
|
| Rate for Payer: Global Benefits Group Commercial |
$112.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$168.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$119.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$110.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$131.32
|
| Rate for Payer: Multiplan Commercial |
$140.70
|
| Rate for Payer: Networks By Design Commercial |
$121.94
|
| Rate for Payer: Prime Health Services Commercial |
$159.46
|
| Rate for Payer: Riverside University Health System MISP |
$75.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$112.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$112.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.80
|
| Rate for Payer: United Healthcare All Other HMO |
$93.80
|
| Rate for Payer: United Healthcare HMO Rider |
$93.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$159.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.46
|
| Rate for Payer: Vantage Medical Group Senior |
$159.46
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$34.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$145.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$94.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$128.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.68
|
| Rate for Payer: Blue Shield of California Commercial |
$108.64
|
| Rate for Payer: Blue Shield of California EPN |
$68.37
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Central Health Plan Commercial |
$137.09
|
| Rate for Payer: Cigna of CA HMO |
$109.67
|
| Rate for Payer: Cigna of CA PPO |
$126.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$145.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$145.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$145.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.54
|
| Rate for Payer: EPIC Health Plan Senior |
$68.54
|
| Rate for Payer: Galaxy Health WC |
$145.66
|
| Rate for Payer: Global Benefits Group Commercial |
$102.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$101.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$119.95
|
| Rate for Payer: Multiplan Commercial |
$128.52
|
| Rate for Payer: Networks By Design Commercial |
$111.38
|
| Rate for Payer: Prime Health Services Commercial |
$145.66
|
| Rate for Payer: Riverside University Health System MISP |
$68.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.68
|
| Rate for Payer: United Healthcare All Other HMO |
$85.68
|
| Rate for Payer: United Healthcare HMO Rider |
$85.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$145.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$145.66
|
| Rate for Payer: Vantage Medical Group Senior |
$145.66
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Adventist Health Commercial |
$34.27
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Central Health Plan Commercial |
$137.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.54
|
| Rate for Payer: EPIC Health Plan Senior |
$68.54
|
| Rate for Payer: Galaxy Health WC |
$145.66
|
| Rate for Payer: Global Benefits Group Commercial |
$102.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$101.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.27
|
| Rate for Payer: Multiplan Commercial |
$128.52
|
| Rate for Payer: Networks By Design Commercial |
$111.38
|
| Rate for Payer: Prime Health Services Commercial |
$145.66
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
OP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$23,685.15 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23,685.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,605.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,553.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,293.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,755.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,003.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,890.26
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: Cigna of CA HMO |
$3,032.00
|
| Rate for Payer: Cigna of CA PPO |
$3,505.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,026.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,026.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,316.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,008.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,719.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,316.25
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
| Rate for Payer: Riverside University Health System MISP |
$1,895.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,842.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,026.88
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
IP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,263.75 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,316.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,008.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
|
|
HC CATH BALLOON DRUG COATED
|
Facility
|
IP
|
$4,750.00
|
|
|
Service Code
|
CPT C2623
|
| Hospital Charge Code |
909081859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Adventist Health Commercial |
$950.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,809.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,394.00
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,325.00
|
| Rate for Payer: Cigna of CA PPO |
$3,325.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,325.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,016.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,802.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,782.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,735.17
|
| Rate for Payer: United Healthcare HMO Rider |
$1,697.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,555.62
|
|
|
HC CATH BALLOON DRUG COATED
|
Facility
|
OP
|
$4,750.00
|
|
|
Service Code
|
CPT C2623
|
| Hospital Charge Code |
909081859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Adventist Health Commercial |
$950.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,612.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,562.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,168.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,604.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3,809.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,394.00
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,325.00
|
| Rate for Payer: Cigna of CA PPO |
$3,325.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,037.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,037.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,325.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,016.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,724.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,802.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,325.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,900.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,850.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,850.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,782.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,735.17
|
| Rate for Payer: United Healthcare HMO Rider |
$1,697.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,555.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,037.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,037.50
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$472.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$345.49
|
| Rate for Payer: Blue Shield of California Commercial |
$505.26
|
| Rate for Payer: Blue Shield of California EPN |
$317.52
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Central Health Plan Commercial |
$504.00
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$535.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$535.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$535.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$472.50
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: Riverside University Health System MISP |
$252.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$535.50
|
| Rate for Payer: Vantage Medical Group Senior |
$535.50
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$505.26
|
| Rate for Payer: Blue Shield of California EPN |
$317.52
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Central Health Plan Commercial |
$504.00
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$472.50
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
IP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$540.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$516.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$638.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$412.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$495.03
|
| Rate for Payer: Blue Shield of California Commercial |
$539.53
|
| Rate for Payer: Blue Shield of California EPN |
$339.55
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$723.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$723.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$723.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$540.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$308.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$595.70
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Riverside University Health System MISP |
$340.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$723.35
|
| Rate for Payer: Vantage Medical Group Senior |
$723.35
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Blue Shield of California Commercial |
$938.34
|
| Rate for Payer: Blue Shield of California EPN |
$589.68
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Central Health Plan Commercial |
$936.00
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,053.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$643.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$877.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$641.63
|
| Rate for Payer: Blue Shield of California Commercial |
$938.34
|
| Rate for Payer: Blue Shield of California EPN |
$589.68
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Central Health Plan Commercial |
$936.00
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$994.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$994.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$994.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,053.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$819.00
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: Riverside University Health System MISP |
$468.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$702.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$994.50
|
| Rate for Payer: Vantage Medical Group Senior |
$994.50
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Blue Shield of California Commercial |
$721.80
|
| Rate for Payer: Blue Shield of California EPN |
$453.60
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Central Health Plan Commercial |
$720.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$810.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$571.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$531.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.00
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$495.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$493.56
|
| Rate for Payer: Blue Shield of California Commercial |
$721.80
|
| Rate for Payer: Blue Shield of California EPN |
$453.60
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Central Health Plan Commercial |
$720.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$765.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$765.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$810.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$571.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$531.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$630.00
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: Riverside University Health System MISP |
$360.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$540.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$540.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$765.00
|
| Rate for Payer: Vantage Medical Group Senior |
$765.00
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
OP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$2,106.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,287.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,755.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,068.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,283.26
|
| Rate for Payer: Blue Shield of California Commercial |
$1,876.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.36
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,989.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,989.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,485.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$849.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,380.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,638.00
|
| Rate for Payer: Multiplan Commercial |
$1,755.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: Riverside University Health System MISP |
$936.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,404.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,989.00
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
IP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$2,106.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,876.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.36
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,485.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,380.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.00
|
| Rate for Payer: Multiplan Commercial |
$1,755.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH BRAUN MULTI TRACK 5FR
|
Facility
|
OP
|
$250.67
|
|
| Hospital Charge Code |
906812268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Adventist Health Commercial |
$50.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$121.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.81
|
| Rate for Payer: Blue Shield of California Commercial |
$158.92
|
| Rate for Payer: Blue Shield of California EPN |
$100.02
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Central Health Plan Commercial |
$200.54
|
| Rate for Payer: Cigna of CA HMO |
$160.43
|
| Rate for Payer: Cigna of CA PPO |
$185.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$213.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$213.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.27
|
| Rate for Payer: EPIC Health Plan Senior |
$100.27
|
| Rate for Payer: Galaxy Health WC |
$213.07
|
| Rate for Payer: Global Benefits Group Commercial |
$150.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$159.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$90.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.47
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: Networks By Design Commercial |
$162.94
|
| Rate for Payer: Prime Health Services Commercial |
$213.07
|
| Rate for Payer: Riverside University Health System MISP |
$100.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$125.33
|
| Rate for Payer: United Healthcare All Other HMO |
$125.33
|
| Rate for Payer: United Healthcare HMO Rider |
$125.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$125.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$213.07
|
| Rate for Payer: Vantage Medical Group Senior |
$213.07
|
|
|
HC CATH BRAUN MULTI TRACK 5FR
|
Facility
|
IP
|
$250.67
|
|
| Hospital Charge Code |
906812268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Adventist Health Commercial |
$50.13
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Central Health Plan Commercial |
$200.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.27
|
| Rate for Payer: EPIC Health Plan Senior |
$100.27
|
| Rate for Payer: Galaxy Health WC |
$213.07
|
| Rate for Payer: Global Benefits Group Commercial |
$150.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$159.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.13
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: Networks By Design Commercial |
$162.94
|
| Rate for Payer: Prime Health Services Commercial |
$213.07
|
|
|
HC CATH BRAUN MULTI TRACK 6FR
|
Facility
|
IP
|
$303.80
|
|
| Hospital Charge Code |
906812437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.76 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Adventist Health Commercial |
$60.76
|
| Rate for Payer: Cash Price |
$136.71
|
| Rate for Payer: Central Health Plan Commercial |
$243.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.52
|
| Rate for Payer: EPIC Health Plan Senior |
$121.52
|
| Rate for Payer: Galaxy Health WC |
$258.23
|
| Rate for Payer: Global Benefits Group Commercial |
$182.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$273.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$179.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.76
|
| Rate for Payer: Multiplan Commercial |
$227.85
|
| Rate for Payer: Networks By Design Commercial |
$197.47
|
| Rate for Payer: Prime Health Services Commercial |
$258.23
|
|
|
HC CATH BRAUN MULTI TRACK 6FR
|
Facility
|
OP
|
$303.80
|
|
| Hospital Charge Code |
906812437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.76 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Adventist Health Commercial |
$60.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$184.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$258.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$167.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$147.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.72
|
| Rate for Payer: Blue Shield of California Commercial |
$192.61
|
| Rate for Payer: Blue Shield of California EPN |
$121.22
|
| Rate for Payer: Cash Price |
$136.71
|
| Rate for Payer: Central Health Plan Commercial |
$243.04
|
| Rate for Payer: Cigna of CA HMO |
$194.43
|
| Rate for Payer: Cigna of CA PPO |
$224.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$258.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$258.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.52
|
| Rate for Payer: EPIC Health Plan Senior |
$121.52
|
| Rate for Payer: Galaxy Health WC |
$258.23
|
| Rate for Payer: Global Benefits Group Commercial |
$182.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$273.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$179.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$212.66
|
| Rate for Payer: Multiplan Commercial |
$227.85
|
| Rate for Payer: Networks By Design Commercial |
$197.47
|
| Rate for Payer: Prime Health Services Commercial |
$258.23
|
| Rate for Payer: Riverside University Health System MISP |
$121.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$182.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$182.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.90
|
| Rate for Payer: United Healthcare All Other HMO |
$151.90
|
| Rate for Payer: United Healthcare HMO Rider |
$151.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$258.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$258.23
|
| Rate for Payer: Vantage Medical Group Senior |
$258.23
|
|
|
HC CATH BROVIAC 4.2FR 90CM PEDS
|
Facility
|
OP
|
$2,535.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901603657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$2,281.50 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,394.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,901.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,157.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,390.19
|
| Rate for Payer: Blue Shield of California Commercial |
$2,033.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.64
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,028.00
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,154.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,154.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,774.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,281.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,609.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$920.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,495.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$507.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,774.50
|
| Rate for Payer: Multiplan Commercial |
$1,901.25
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,014.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,521.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,154.75
|
|
|
HC CATH BROVIAC 4.2FR 90CM PEDS
|
Facility
|
IP
|
$2,535.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901603657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$2,281.50 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,033.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.64
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,028.00
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,774.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,281.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,609.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,495.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$507.00
|
| Rate for Payer: Multiplan Commercial |
$1,901.25
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
|
