|
HC CATH COUDE 12FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| 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 Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| 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
|
|
|
HC CATH COUDE 14FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
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
|
|
|
HC CATH COUDE 14FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| 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 Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| 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
|
|
|
HC CATH COUDE 18FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
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
|
|
|
HC CATH COUDE 18FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| 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 Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| 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
|
|
|
HC CATH COUDE 20FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
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
|
|
|
HC CATH COUDE 20FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| 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 Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| 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
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
OP
|
$38.38
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.33
|
| Rate for Payer: Blue Shield of California Commercial |
$24.33
|
| Rate for Payer: Blue Shield of California EPN |
$15.31
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: Cigna of CA HMO |
$24.56
|
| Rate for Payer: Cigna of CA PPO |
$28.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
| Rate for Payer: Riverside University Health System MISP |
$15.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.19
|
| Rate for Payer: United Healthcare HMO Rider |
$19.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.62
|
| Rate for Payer: Vantage Medical Group Senior |
$32.62
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
IP
|
$38.38
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
IP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
OP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.86
|
| Rate for Payer: Blue Shield of California Commercial |
$30.36
|
| Rate for Payer: Blue Shield of California EPN |
$19.11
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: Cigna of CA HMO |
$30.65
|
| Rate for Payer: Cigna of CA PPO |
$35.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33.52
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
| Rate for Payer: Riverside University Health System MISP |
$19.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.95
|
| Rate for Payer: United Healthcare All Other HMO |
$23.95
|
| Rate for Payer: United Healthcare HMO Rider |
$23.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.71
|
| Rate for Payer: Vantage Medical Group Senior |
$40.71
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
OP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$530.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$423.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$508.41
|
| Rate for Payer: Blue Shield of California Commercial |
$554.12
|
| Rate for Payer: Blue Shield of California EPN |
$348.73
|
| Rate for Payer: Cash Price |
$393.30
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Riverside University Health System MISP |
$349.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
IP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$393.30
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
OP
|
$960.89
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.18 |
| Max. Negotiated Rate |
$864.80 |
| Rate for Payer: Adventist Health Commercial |
$192.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$583.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$816.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$720.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$558.95
|
| Rate for Payer: Blue Shield of California Commercial |
$609.20
|
| Rate for Payer: Blue Shield of California EPN |
$383.40
|
| Rate for Payer: Cash Price |
$432.40
|
| Rate for Payer: Central Health Plan Commercial |
$768.71
|
| Rate for Payer: Cigna of CA HMO |
$614.97
|
| Rate for Payer: Cigna of CA PPO |
$711.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$816.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$816.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$816.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.36
|
| Rate for Payer: EPIC Health Plan Senior |
$384.36
|
| Rate for Payer: Galaxy Health WC |
$816.76
|
| Rate for Payer: Global Benefits Group Commercial |
$576.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$348.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$566.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$672.62
|
| Rate for Payer: Multiplan Commercial |
$720.67
|
| Rate for Payer: Networks By Design Commercial |
$624.58
|
| Rate for Payer: Prime Health Services Commercial |
$816.76
|
| Rate for Payer: Riverside University Health System MISP |
$384.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.44
|
| Rate for Payer: United Healthcare All Other HMO |
$480.44
|
| Rate for Payer: United Healthcare HMO Rider |
$480.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$816.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$816.76
|
| Rate for Payer: Vantage Medical Group Senior |
$816.76
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
IP
|
$960.89
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.18 |
| Max. Negotiated Rate |
$864.80 |
| Rate for Payer: Adventist Health Commercial |
$192.18
|
| Rate for Payer: Cash Price |
$432.40
|
| Rate for Payer: Central Health Plan Commercial |
$768.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.36
|
| Rate for Payer: EPIC Health Plan Senior |
$384.36
|
| Rate for Payer: Galaxy Health WC |
$816.76
|
| Rate for Payer: Global Benefits Group Commercial |
$576.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$566.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.18
|
| Rate for Payer: Multiplan Commercial |
$720.67
|
| Rate for Payer: Networks By Design Commercial |
$624.58
|
| Rate for Payer: Prime Health Services Commercial |
$816.76
|
|
|
HC CATH CV 7FR 6" TL FULL TRAY
|
Facility
|
OP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Adventist Health Commercial |
$121.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$333.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$454.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$276.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$332.06
|
| Rate for Payer: Blue Shield of California Commercial |
$485.61
|
| Rate for Payer: Blue Shield of California EPN |
$305.17
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Senior |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.67
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$384.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$219.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$357.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$423.85
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.67
|
| Rate for Payer: Riverside University Health System MISP |
$242.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.24
|
| Rate for Payer: United Healthcare All Other HMO |
$221.19
|
| Rate for Payer: United Healthcare HMO Rider |
$216.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$514.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.67
|
| Rate for Payer: Vantage Medical Group Senior |
$514.67
|
|
|
HC CATH CV 7FR 6" TL FULL TRAY
|
Facility
|
IP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Adventist Health Commercial |
$121.10
|
| Rate for Payer: Blue Shield of California Commercial |
$485.61
|
| Rate for Payer: Blue Shield of California EPN |
$305.17
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Senior |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.67
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$384.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$357.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.24
|
| Rate for Payer: United Healthcare All Other HMO |
$221.19
|
| Rate for Payer: United Healthcare HMO Rider |
$216.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.30
|
|
|
HC CATH CV 7FR 8" TL FULL TRAY
|
Facility
|
OP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Adventist Health Commercial |
$121.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$333.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$454.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$276.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$332.06
|
| Rate for Payer: Blue Shield of California Commercial |
$485.61
|
| Rate for Payer: Blue Shield of California EPN |
$305.17
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Senior |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.67
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$384.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$219.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$357.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$423.85
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.67
|
| Rate for Payer: Riverside University Health System MISP |
$242.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.24
|
| Rate for Payer: United Healthcare All Other HMO |
$221.19
|
| Rate for Payer: United Healthcare HMO Rider |
$216.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$514.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.67
|
| Rate for Payer: Vantage Medical Group Senior |
$514.67
|
|
|
HC CATH CV 7FR 8" TL FULL TRAY
|
Facility
|
IP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Adventist Health Commercial |
$121.10
|
| Rate for Payer: Blue Shield of California Commercial |
$485.61
|
| Rate for Payer: Blue Shield of California EPN |
$305.17
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Senior |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.67
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$384.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$357.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.24
|
| Rate for Payer: United Healthcare All Other HMO |
$221.19
|
| Rate for Payer: United Healthcare HMO Rider |
$216.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.30
|
|
|
HC CATH CV 8FR 6" DL FULL TRAY
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607562
|
|
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 CV 8FR 6" DL FULL TRAY
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607562
|
|
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 DIALYSIS 13FR 15CM TRIALYSIS CURVED
|
Facility
|
OP
|
$780.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.03 |
| Max. Negotiated Rate |
$702.14 |
| Rate for Payer: Adventist Health Commercial |
$156.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$663.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$429.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$585.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$356.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$427.84
|
| Rate for Payer: Blue Shield of California Commercial |
$625.69
|
| Rate for Payer: Blue Shield of California EPN |
$393.20
|
| Rate for Payer: Cash Price |
$351.07
|
| Rate for Payer: Central Health Plan Commercial |
$624.13
|
| Rate for Payer: Cigna of CA HMO |
$546.11
|
| Rate for Payer: Cigna of CA PPO |
$546.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$663.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$663.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$663.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$546.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.06
|
| Rate for Payer: EPIC Health Plan Senior |
$312.06
|
| Rate for Payer: Galaxy Health WC |
$663.14
|
| Rate for Payer: Global Benefits Group Commercial |
$468.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$495.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$283.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$460.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$546.11
|
| Rate for Payer: Multiplan Commercial |
$585.12
|
| Rate for Payer: Networks By Design Commercial |
$390.08
|
| Rate for Payer: Prime Health Services Commercial |
$663.14
|
| Rate for Payer: Riverside University Health System MISP |
$312.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$468.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$468.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$292.79
|
| Rate for Payer: United Healthcare All Other HMO |
$284.99
|
| Rate for Payer: United Healthcare HMO Rider |
$278.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$255.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$663.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$663.14
|
| Rate for Payer: Vantage Medical Group Senior |
$663.14
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED
|
Facility
|
IP
|
$780.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.03 |
| Max. Negotiated Rate |
$702.14 |
| Rate for Payer: Adventist Health Commercial |
$156.03
|
| Rate for Payer: Blue Shield of California Commercial |
$625.69
|
| Rate for Payer: Blue Shield of California EPN |
$393.20
|
| Rate for Payer: Cash Price |
$351.07
|
| Rate for Payer: Central Health Plan Commercial |
$624.13
|
| Rate for Payer: Cigna of CA HMO |
$546.11
|
| Rate for Payer: Cigna of CA PPO |
$546.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$546.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.06
|
| Rate for Payer: EPIC Health Plan Senior |
$312.06
|
| Rate for Payer: Galaxy Health WC |
$663.14
|
| Rate for Payer: Global Benefits Group Commercial |
$468.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$495.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$460.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.03
|
| Rate for Payer: Multiplan Commercial |
$585.12
|
| Rate for Payer: Networks By Design Commercial |
$390.08
|
| Rate for Payer: Prime Health Services Commercial |
$663.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$292.79
|
| Rate for Payer: United Healthcare All Other HMO |
$284.99
|
| Rate for Payer: United Healthcare HMO Rider |
$278.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$255.50
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED LEG
|
Facility
|
IP
|
$1,030.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.02 |
| Max. Negotiated Rate |
$927.11 |
| Rate for Payer: Adventist Health Commercial |
$206.02
|
| Rate for Payer: Blue Shield of California Commercial |
$826.16
|
| Rate for Payer: Blue Shield of California EPN |
$519.18
|
| Rate for Payer: Cash Price |
$463.55
|
| Rate for Payer: Central Health Plan Commercial |
$824.10
|
| Rate for Payer: Cigna of CA HMO |
$721.08
|
| Rate for Payer: Cigna of CA PPO |
$721.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$721.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.05
|
| Rate for Payer: EPIC Health Plan Senior |
$412.05
|
| Rate for Payer: Galaxy Health WC |
$875.60
|
| Rate for Payer: Global Benefits Group Commercial |
$618.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$654.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$607.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.02
|
| Rate for Payer: Multiplan Commercial |
$772.59
|
| Rate for Payer: Networks By Design Commercial |
$515.06
|
| Rate for Payer: Prime Health Services Commercial |
$875.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$386.60
|
| Rate for Payer: United Healthcare All Other HMO |
$376.30
|
| Rate for Payer: United Healthcare HMO Rider |
$368.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.36
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED LEG
|
Facility
|
OP
|
$1,030.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.02 |
| Max. Negotiated Rate |
$927.11 |
| Rate for Payer: Adventist Health Commercial |
$206.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$875.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$772.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$470.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$564.92
|
| Rate for Payer: Blue Shield of California Commercial |
$826.16
|
| Rate for Payer: Blue Shield of California EPN |
$519.18
|
| Rate for Payer: Cash Price |
$463.55
|
| Rate for Payer: Central Health Plan Commercial |
$824.10
|
| Rate for Payer: Cigna of CA HMO |
$721.08
|
| Rate for Payer: Cigna of CA PPO |
$721.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$875.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$875.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$721.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.05
|
| Rate for Payer: EPIC Health Plan Senior |
$412.05
|
| Rate for Payer: Galaxy Health WC |
$875.60
|
| Rate for Payer: Global Benefits Group Commercial |
$618.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$654.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$373.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$607.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$721.08
|
| Rate for Payer: Multiplan Commercial |
$772.59
|
| Rate for Payer: Networks By Design Commercial |
$515.06
|
| Rate for Payer: Prime Health Services Commercial |
$875.60
|
| Rate for Payer: Riverside University Health System MISP |
$412.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$386.60
|
| Rate for Payer: United Healthcare All Other HMO |
$376.30
|
| Rate for Payer: United Healthcare HMO Rider |
$368.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$875.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.60
|
| Rate for Payer: Vantage Medical Group Senior |
$875.60
|
|
