|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,050.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,261.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,844.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,844.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
OP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$471.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$365.97
|
| Rate for Payer: Blue Shield of California Commercial |
$398.87
|
| Rate for Payer: Blue Shield of California EPN |
$251.03
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: Cigna of CA HMO |
$402.65
|
| Rate for Payer: Cigna of CA PPO |
$465.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$534.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$440.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$399.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$440.40
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
| Rate for Payer: Riverside University Health System MISP |
$251.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$377.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.57
|
| Rate for Payer: United Healthcare All Other HMO |
$314.57
|
| Rate for Payer: United Healthcare HMO Rider |
$314.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.77
|
| Rate for Payer: Vantage Medical Group Senior |
$534.77
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
IP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$566.23 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$440.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$399.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Blue Shield of California Commercial |
$355.38
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.01
|
| Rate for Payer: Blue Shield of California Commercial |
$355.38
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Riverside University Health System MISP |
$177.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Blue Shield of California Commercial |
$355.38
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
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 CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.01
|
| Rate for Payer: Blue Shield of California Commercial |
$355.38
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Riverside University Health System MISP |
$177.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
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 CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.94
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
OP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$790.74 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$658.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$401.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$481.82
|
| Rate for Payer: Blue Shield of California Commercial |
$704.64
|
| Rate for Payer: Blue Shield of California EPN |
$442.81
|
| Rate for Payer: Cash Price |
$395.37
|
| Rate for Payer: Central Health Plan Commercial |
$702.88
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$746.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$746.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$615.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$557.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$318.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$518.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$615.02
|
| Rate for Payer: Multiplan Commercial |
$658.95
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: Riverside University Health System MISP |
$351.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$746.81
|
| Rate for Payer: Vantage Medical Group Senior |
$746.81
|
|
|
HC CATH CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
IP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$790.74 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Blue Shield of California Commercial |
$704.64
|
| Rate for Payer: Blue Shield of California EPN |
$442.81
|
| Rate for Payer: Cash Price |
$395.37
|
| Rate for Payer: Central Health Plan Commercial |
$702.88
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$615.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$557.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$518.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.72
|
| Rate for Payer: Multiplan Commercial |
$658.95
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
IP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
OP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.05
|
| Rate for Payer: Blue Shield of California Commercial |
$4.42
|
| Rate for Payer: Blue Shield of California EPN |
$2.78
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC CATH COOK CORONARY
|
Facility
|
IP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$148.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
|
|
HC CATH COOK CORONARY
|
Facility
|
OP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.59
|
| Rate for Payer: Blue Shield of California Commercial |
$159.77
|
| Rate for Payer: Blue Shield of California EPN |
$100.55
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: Cigna of CA HMO |
$161.28
|
| Rate for Payer: Cigna of CA PPO |
$186.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$148.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Riverside University Health System MISP |
$100.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$126.00
|
| Rate for Payer: United Healthcare All Other HMO |
$126.00
|
| Rate for Payer: United Healthcare HMO Rider |
$126.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$104.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$94.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.65
|
| Rate for Payer: Blue Shield of California Commercial |
$94.44
|
| Rate for Payer: Blue Shield of California EPN |
$59.44
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$104.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$94.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Riverside University Health System MISP |
$59.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
IP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
OP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.58
|
| Rate for Payer: Blue Shield of California Commercial |
$86.73
|
| Rate for Payer: Blue Shield of California EPN |
$54.58
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: Cigna of CA HMO |
$87.55
|
| Rate for Payer: Cigna of CA PPO |
$101.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$95.76
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
| Rate for Payer: Riverside University Health System MISP |
$54.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.40
|
| Rate for Payer: United Healthcare All Other HMO |
$68.40
|
| Rate for Payer: United Healthcare HMO Rider |
$68.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.28
|
| Rate for Payer: Vantage Medical Group Senior |
$116.28
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
IP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$486.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$441.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$410.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
OP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$382.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$521.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$404.58
|
| Rate for Payer: Blue Shield of California Commercial |
$440.96
|
| Rate for Payer: Blue Shield of California EPN |
$277.51
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: Cigna of CA HMO |
$445.13
|
| Rate for Payer: Cigna of CA PPO |
$514.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$591.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$591.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$591.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$486.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$441.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$252.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$410.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$486.86
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
| Rate for Payer: Riverside University Health System MISP |
$278.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$417.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$417.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.76
|
| Rate for Payer: United Healthcare All Other HMO |
$347.76
|
| Rate for Payer: United Healthcare HMO Rider |
$347.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$347.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$591.19
|
| Rate for Payer: Vantage Medical Group Senior |
$591.19
|
|
|
HC CATH COUDE 12FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.18
|
| Rate for Payer: Blue Shield of California Commercial |
$23.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.53
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Riverside University Health System MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
