|
HC CATH DIALYSIS 13FR 20CM TRIALYSIS STRAIGHT LEG
|
Facility
|
IP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.25 |
| Rate for Payer: Adventist Health Commercial |
$195.39
|
| Rate for Payer: Blue Shield of California Commercial |
$783.51
|
| Rate for Payer: Blue Shield of California EPN |
$492.38
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.87
|
| Rate for Payer: Cigna of CA PPO |
$683.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$683.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Senior |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$620.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$576.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$366.65
|
| Rate for Payer: United Healthcare All Other HMO |
$356.88
|
| Rate for Payer: United Healthcare HMO Rider |
$349.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.95
|
|
|
HC CATH DIALYSIS 13FR 20CM TRIALYSIS STRAIGHT LEG
|
Facility
|
OP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.25 |
| Rate for Payer: Adventist Health Commercial |
$195.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$537.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$732.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$446.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$535.76
|
| Rate for Payer: Blue Shield of California Commercial |
$783.51
|
| Rate for Payer: Blue Shield of California EPN |
$492.38
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.87
|
| Rate for Payer: Cigna of CA PPO |
$683.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$830.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$830.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$683.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Senior |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$620.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$354.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$576.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$683.87
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: Riverside University Health System MISP |
$390.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$586.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$586.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$366.65
|
| Rate for Payer: United Healthcare All Other HMO |
$356.88
|
| Rate for Payer: United Healthcare HMO Rider |
$349.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$830.41
|
| Rate for Payer: Vantage Medical Group Senior |
$830.41
|
|
|
HC CATH DIALYSIS 13FR 24CM TRIALYSIS STRAIGHT
|
Facility
|
OP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.25 |
| Rate for Payer: Adventist Health Commercial |
$195.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$537.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$732.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$446.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$535.76
|
| Rate for Payer: Blue Shield of California Commercial |
$783.51
|
| Rate for Payer: Blue Shield of California EPN |
$492.38
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.87
|
| Rate for Payer: Cigna of CA PPO |
$683.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$830.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$830.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$683.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Senior |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$620.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$354.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$576.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$683.87
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: Riverside University Health System MISP |
$390.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$586.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$586.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$366.65
|
| Rate for Payer: United Healthcare All Other HMO |
$356.88
|
| Rate for Payer: United Healthcare HMO Rider |
$349.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$830.41
|
| Rate for Payer: Vantage Medical Group Senior |
$830.41
|
|
|
HC CATH DIALYSIS 13FR 24CM TRIALYSIS STRAIGHT
|
Facility
|
IP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.25 |
| Rate for Payer: Adventist Health Commercial |
$195.39
|
| Rate for Payer: Blue Shield of California Commercial |
$783.51
|
| Rate for Payer: Blue Shield of California EPN |
$492.38
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.87
|
| Rate for Payer: Cigna of CA PPO |
$683.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$683.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Senior |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$620.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$576.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$366.65
|
| Rate for Payer: United Healthcare All Other HMO |
$356.88
|
| Rate for Payer: United Healthcare HMO Rider |
$349.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.95
|
|
|
HC CATH DIALYSIS CRCT W STNT PLC
|
Facility
|
OP
|
$27,832.00
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
909036903
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,566.40 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,566.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$12,524.40
|
| Rate for Payer: Cash Price |
$12,524.40
|
| Rate for Payer: Cash Price |
$12,524.40
|
| Rate for Payer: Central Health Plan Commercial |
$22,265.60
|
| Rate for Payer: Cigna of CA HMO |
$17,812.48
|
| Rate for Payer: Cigna of CA PPO |
$20,595.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$23,657.20
|
| Rate for Payer: Global Benefits Group Commercial |
$16,699.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,048.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,900.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,673.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,832.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,566.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$20,874.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$18,090.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$23,657.20
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,699.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,916.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC CATH DIALYSIS CRCT W STNT PLC
|
Facility
|
IP
|
$27,832.00
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
909036903
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,566.40 |
| Max. Negotiated Rate |
$25,048.80 |
| Rate for Payer: Adventist Health Commercial |
$5,566.40
|
| Rate for Payer: Cash Price |
$12,524.40
|
| Rate for Payer: Central Health Plan Commercial |
$22,265.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,132.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,132.80
|
| Rate for Payer: Galaxy Health WC |
$23,657.20
|
| Rate for Payer: Global Benefits Group Commercial |
$16,699.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,048.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,673.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,420.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,566.40
|
| Rate for Payer: Multiplan Commercial |
$20,874.00
|
| Rate for Payer: Networks By Design Commercial |
$18,090.80
|
| Rate for Payer: Prime Health Services Commercial |
$23,657.20
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
OP
|
$12,079.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
909036902
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,912.74 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,415.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,542.58
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$5,435.55
|
| Rate for Payer: Cash Price |
$5,435.55
|
| Rate for Payer: Cash Price |
$5,435.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,663.20
|
| Rate for Payer: Cigna of CA HMO |
$7,730.56
|
| Rate for Payer: Cigna of CA PPO |
$8,938.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,455.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$10,267.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,247.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,871.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,912.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,670.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,112.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,415.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$9,059.25
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$7,851.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Preferred Health Network WC |
$11,778.14
|
| Rate for Payer: Prime Health Services Commercial |
$10,267.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,247.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,039.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
IP
|
$12,079.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
909036902
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,415.80 |
| Max. Negotiated Rate |
$10,871.10 |
| Rate for Payer: Adventist Health Commercial |
$2,415.80
|
| Rate for Payer: Cash Price |
$5,435.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,663.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,455.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,831.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,831.60
|
| Rate for Payer: Galaxy Health WC |
$10,267.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,247.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,871.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,670.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,126.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,415.80
|
| Rate for Payer: Multiplan Commercial |
$9,059.25
|
| Rate for Payer: Networks By Design Commercial |
$7,851.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,267.15
|
|
|
HC CATH DIALYSIS TRAY 2LUMEN 13FR
|
Facility
|
IP
|
$2,326.66
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.33 |
| Max. Negotiated Rate |
$2,093.99 |
| Rate for Payer: Adventist Health Commercial |
$465.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,865.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,172.64
|
| Rate for Payer: Cash Price |
$1,047.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,861.33
|
| Rate for Payer: Cigna of CA HMO |
$1,628.66
|
| Rate for Payer: Cigna of CA PPO |
$1,628.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,628.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.66
|
| Rate for Payer: EPIC Health Plan Senior |
$930.66
|
| Rate for Payer: Galaxy Health WC |
$1,977.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,093.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,477.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,372.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$465.33
|
| Rate for Payer: Multiplan Commercial |
$1,744.99
|
| Rate for Payer: Networks By Design Commercial |
$1,163.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,977.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$873.20
|
| Rate for Payer: United Healthcare All Other HMO |
$849.93
|
| Rate for Payer: United Healthcare HMO Rider |
$831.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$761.98
|
|
|
HC CATH DIALYSIS TRAY 2LUMEN 13FR
|
Facility
|
OP
|
$2,326.66
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.33 |
| Max. Negotiated Rate |
$2,093.99 |
| Rate for Payer: Adventist Health Commercial |
$465.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,977.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,279.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,744.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,062.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,275.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,865.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,172.64
|
| Rate for Payer: Cash Price |
$1,047.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,861.33
|
| Rate for Payer: Cigna of CA HMO |
$1,628.66
|
| Rate for Payer: Cigna of CA PPO |
$1,628.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,977.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,977.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,977.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,628.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.66
|
| Rate for Payer: EPIC Health Plan Senior |
$930.66
|
| Rate for Payer: Galaxy Health WC |
$1,977.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,093.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,477.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$844.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,372.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$465.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,628.66
|
| Rate for Payer: Multiplan Commercial |
$1,744.99
|
| Rate for Payer: Networks By Design Commercial |
$1,163.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,977.66
|
| Rate for Payer: Riverside University Health System MISP |
$930.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$873.20
|
| Rate for Payer: United Healthcare All Other HMO |
$849.93
|
| Rate for Payer: United Healthcare HMO Rider |
$831.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$761.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,977.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,977.66
|
| Rate for Payer: Vantage Medical Group Senior |
$1,977.66
|
|
|
HC CATH DRAINAGE PLEURX PLEURAL KIT
|
Facility
|
OP
|
$2,636.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.20 |
| Max. Negotiated Rate |
$2,372.40 |
| Rate for Payer: Adventist Health Commercial |
$527.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,449.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,977.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,203.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,445.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,114.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,328.54
|
| Rate for Payer: Cash Price |
$1,186.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,108.80
|
| Rate for Payer: Cigna of CA HMO |
$1,845.20
|
| Rate for Payer: Cigna of CA PPO |
$1,845.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,240.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,240.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,845.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,054.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,054.40
|
| Rate for Payer: Galaxy Health WC |
$2,240.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,581.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,372.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,673.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$956.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$527.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,845.20
|
| Rate for Payer: Multiplan Commercial |
$1,977.00
|
| Rate for Payer: Networks By Design Commercial |
$1,318.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,240.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,054.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,581.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,581.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.29
|
| Rate for Payer: United Healthcare All Other HMO |
$962.93
|
| Rate for Payer: United Healthcare HMO Rider |
$942.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$863.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,240.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,240.60
|
|
|
HC CATH DRAINAGE PLEURX PLEURAL KIT
|
Facility
|
IP
|
$2,636.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.20 |
| Max. Negotiated Rate |
$2,372.40 |
| Rate for Payer: Adventist Health Commercial |
$527.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,114.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,328.54
|
| Rate for Payer: Cash Price |
$1,186.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,108.80
|
| Rate for Payer: Cigna of CA HMO |
$1,845.20
|
| Rate for Payer: Cigna of CA PPO |
$1,845.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,845.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,054.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,054.40
|
| Rate for Payer: Galaxy Health WC |
$2,240.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,581.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,372.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,673.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$527.20
|
| Rate for Payer: Multiplan Commercial |
$1,977.00
|
| Rate for Payer: Networks By Design Commercial |
$1,318.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.29
|
| Rate for Payer: United Healthcare All Other HMO |
$962.93
|
| Rate for Payer: United Healthcare HMO Rider |
$942.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$863.29
|
|
|
HC CATH DRAIN EXTERNAL
|
Facility
|
OP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Adventist Health Commercial |
$176.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$537.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$752.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$486.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$663.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$428.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.72
|
| Rate for Payer: Blue Shield of California Commercial |
$561.00
|
| Rate for Payer: Blue Shield of California EPN |
$353.06
|
| Rate for Payer: Cash Price |
$398.19
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: Cigna of CA HMO |
$566.31
|
| Rate for Payer: Cigna of CA PPO |
$654.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$752.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$752.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$619.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: EPIC Health Plan Senior |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$561.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$321.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$522.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$619.40
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
| Rate for Payer: Riverside University Health System MISP |
$353.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$530.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$530.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$442.43
|
| Rate for Payer: United Healthcare All Other HMO |
$442.43
|
| Rate for Payer: United Healthcare HMO Rider |
$442.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$442.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$752.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.13
|
| Rate for Payer: Vantage Medical Group Senior |
$752.13
|
|
|
HC CATH DRAIN EXTERNAL
|
Facility
|
IP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Adventist Health Commercial |
$176.97
|
| Rate for Payer: Cash Price |
$398.19
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$619.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: EPIC Health Plan Senior |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$561.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$522.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
OP
|
$759.05
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.81 |
| Max. Negotiated Rate |
$683.14 |
| Rate for Payer: Adventist Health Commercial |
$151.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$645.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$569.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$346.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$416.26
|
| Rate for Payer: Blue Shield of California Commercial |
$608.76
|
| Rate for Payer: Blue Shield of California EPN |
$382.56
|
| Rate for Payer: Cash Price |
$341.57
|
| Rate for Payer: Central Health Plan Commercial |
$607.24
|
| Rate for Payer: Cigna of CA HMO |
$531.34
|
| Rate for Payer: Cigna of CA PPO |
$531.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$645.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$645.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$645.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$531.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.62
|
| Rate for Payer: EPIC Health Plan Senior |
$303.62
|
| Rate for Payer: Galaxy Health WC |
$645.19
|
| Rate for Payer: Global Benefits Group Commercial |
$455.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$482.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$275.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$531.34
|
| Rate for Payer: Multiplan Commercial |
$569.29
|
| Rate for Payer: Networks By Design Commercial |
$379.52
|
| Rate for Payer: Prime Health Services Commercial |
$645.19
|
| Rate for Payer: Riverside University Health System MISP |
$303.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$455.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$455.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$284.87
|
| Rate for Payer: United Healthcare All Other HMO |
$277.28
|
| Rate for Payer: United Healthcare HMO Rider |
$271.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$248.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$645.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$645.19
|
| Rate for Payer: Vantage Medical Group Senior |
$645.19
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
IP
|
$759.05
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.81 |
| Max. Negotiated Rate |
$683.14 |
| Rate for Payer: Adventist Health Commercial |
$151.81
|
| Rate for Payer: Blue Shield of California Commercial |
$608.76
|
| Rate for Payer: Blue Shield of California EPN |
$382.56
|
| Rate for Payer: Cash Price |
$341.57
|
| Rate for Payer: Central Health Plan Commercial |
$607.24
|
| Rate for Payer: Cigna of CA HMO |
$531.34
|
| Rate for Payer: Cigna of CA PPO |
$531.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$531.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.62
|
| Rate for Payer: EPIC Health Plan Senior |
$303.62
|
| Rate for Payer: Galaxy Health WC |
$645.19
|
| Rate for Payer: Global Benefits Group Commercial |
$455.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$482.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$447.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.81
|
| Rate for Payer: Multiplan Commercial |
$569.29
|
| Rate for Payer: Networks By Design Commercial |
$379.52
|
| Rate for Payer: Prime Health Services Commercial |
$645.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$284.87
|
| Rate for Payer: United Healthcare All Other HMO |
$277.28
|
| Rate for Payer: United Healthcare HMO Rider |
$271.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$248.59
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
IP
|
$635.77
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.15 |
| Max. Negotiated Rate |
$572.19 |
| Rate for Payer: Adventist Health Commercial |
$127.15
|
| Rate for Payer: Blue Shield of California Commercial |
$509.89
|
| Rate for Payer: Blue Shield of California EPN |
$320.43
|
| Rate for Payer: Cash Price |
$286.10
|
| Rate for Payer: Central Health Plan Commercial |
$508.62
|
| Rate for Payer: Cigna of CA HMO |
$445.04
|
| Rate for Payer: Cigna of CA PPO |
$445.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$445.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.31
|
| Rate for Payer: EPIC Health Plan Senior |
$254.31
|
| Rate for Payer: Galaxy Health WC |
$540.40
|
| Rate for Payer: Global Benefits Group Commercial |
$381.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$375.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.15
|
| Rate for Payer: Multiplan Commercial |
$476.83
|
| Rate for Payer: Networks By Design Commercial |
$317.88
|
| Rate for Payer: Prime Health Services Commercial |
$540.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.60
|
| Rate for Payer: United Healthcare All Other HMO |
$232.25
|
| Rate for Payer: United Healthcare HMO Rider |
$227.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.21
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
OP
|
$635.77
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.15 |
| Max. Negotiated Rate |
$572.19 |
| Rate for Payer: Adventist Health Commercial |
$127.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$540.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$290.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$348.66
|
| Rate for Payer: Blue Shield of California Commercial |
$509.89
|
| Rate for Payer: Blue Shield of California EPN |
$320.43
|
| Rate for Payer: Cash Price |
$286.10
|
| Rate for Payer: Central Health Plan Commercial |
$508.62
|
| Rate for Payer: Cigna of CA HMO |
$445.04
|
| Rate for Payer: Cigna of CA PPO |
$445.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$540.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$540.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$540.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$445.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.31
|
| Rate for Payer: EPIC Health Plan Senior |
$254.31
|
| Rate for Payer: Galaxy Health WC |
$540.40
|
| Rate for Payer: Global Benefits Group Commercial |
$381.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$230.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$375.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$445.04
|
| Rate for Payer: Multiplan Commercial |
$476.83
|
| Rate for Payer: Networks By Design Commercial |
$317.88
|
| Rate for Payer: Prime Health Services Commercial |
$540.40
|
| Rate for Payer: Riverside University Health System MISP |
$254.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.60
|
| Rate for Payer: United Healthcare All Other HMO |
$232.25
|
| Rate for Payer: United Healthcare HMO Rider |
$227.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$540.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$540.40
|
| Rate for Payer: Vantage Medical Group Senior |
$540.40
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
IP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Adventist Health Commercial |
$118.04
|
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$413.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: EPIC Health Plan Senior |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$374.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$348.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Multiplan Commercial |
$442.63
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
OP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Adventist Health Commercial |
$118.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$501.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$442.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$285.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.31
|
| Rate for Payer: Blue Shield of California Commercial |
$374.17
|
| Rate for Payer: Blue Shield of California EPN |
$235.48
|
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: Cigna of CA HMO |
$377.72
|
| Rate for Payer: Cigna of CA PPO |
$436.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$501.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$501.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$501.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$413.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: EPIC Health Plan Senior |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$374.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$214.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$348.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$413.13
|
| Rate for Payer: Multiplan Commercial |
$442.63
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
| Rate for Payer: Riverside University Health System MISP |
$236.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$354.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$354.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$295.09
|
| Rate for Payer: United Healthcare All Other HMO |
$295.09
|
| Rate for Payer: United Healthcare HMO Rider |
$295.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$501.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$501.65
|
| Rate for Payer: Vantage Medical Group Senior |
$501.65
|
|
|
HC CATH DRAIN SET PNEUMOPERIC 6FR
|
Facility
|
IP
|
$604.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.89 |
| Max. Negotiated Rate |
$544.00 |
| Rate for Payer: Adventist Health Commercial |
$120.89
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Central Health Plan Commercial |
$483.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.78
|
| Rate for Payer: EPIC Health Plan Senior |
$241.78
|
| Rate for Payer: Galaxy Health WC |
$513.77
|
| Rate for Payer: Global Benefits Group Commercial |
$362.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$383.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.89
|
| Rate for Payer: Multiplan Commercial |
$453.33
|
| Rate for Payer: Networks By Design Commercial |
$392.89
|
| Rate for Payer: Prime Health Services Commercial |
$513.77
|
|
|
HC CATH DRAIN SET PNEUMOPERIC 6FR
|
Facility
|
OP
|
$604.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.89 |
| Max. Negotiated Rate |
$544.00 |
| Rate for Payer: Adventist Health Commercial |
$120.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$513.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$332.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$292.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.60
|
| Rate for Payer: Blue Shield of California Commercial |
$383.21
|
| Rate for Payer: Blue Shield of California EPN |
$241.17
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Central Health Plan Commercial |
$483.55
|
| Rate for Payer: Cigna of CA HMO |
$386.84
|
| Rate for Payer: Cigna of CA PPO |
$447.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$513.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$513.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$513.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$423.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.78
|
| Rate for Payer: EPIC Health Plan Senior |
$241.78
|
| Rate for Payer: Galaxy Health WC |
$513.77
|
| Rate for Payer: Global Benefits Group Commercial |
$362.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$383.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$219.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$423.11
|
| Rate for Payer: Multiplan Commercial |
$453.33
|
| Rate for Payer: Networks By Design Commercial |
$392.89
|
| Rate for Payer: Prime Health Services Commercial |
$513.77
|
| Rate for Payer: Riverside University Health System MISP |
$241.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$362.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$362.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.22
|
| Rate for Payer: United Healthcare All Other HMO |
$302.22
|
| Rate for Payer: United Healthcare HMO Rider |
$302.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$513.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$513.77
|
| Rate for Payer: Vantage Medical Group Senior |
$513.77
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
IP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Adventist Health Commercial |
$60.35
|
| Rate for Payer: Cash Price |
$135.80
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$211.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Senior |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
OP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Adventist Health Commercial |
$60.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$183.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.54
|
| Rate for Payer: Blue Shield of California Commercial |
$191.32
|
| Rate for Payer: Blue Shield of California EPN |
$120.41
|
| Rate for Payer: Cash Price |
$135.80
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: Cigna of CA HMO |
$193.13
|
| Rate for Payer: Cigna of CA PPO |
$223.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$256.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$211.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Senior |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$211.24
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
| Rate for Payer: Riverside University Health System MISP |
$120.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.88
|
| Rate for Payer: United Healthcare All Other HMO |
$150.88
|
| Rate for Payer: United Healthcare HMO Rider |
$150.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.50
|
| Rate for Payer: Vantage Medical Group Senior |
$256.50
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
OP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$206.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$164.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.98
|
| Rate for Payer: Blue Shield of California Commercial |
$215.78
|
| Rate for Payer: Blue Shield of California EPN |
$135.80
|
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: Cigna of CA HMO |
$217.82
|
| Rate for Payer: Cigna of CA PPO |
$251.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$289.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$289.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$238.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$216.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$238.24
|
| Rate for Payer: Multiplan Commercial |
$255.25
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
| Rate for Payer: Riverside University Health System MISP |
$136.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$170.17
|
| Rate for Payer: United Healthcare All Other HMO |
$170.17
|
| Rate for Payer: United Healthcare HMO Rider |
$170.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$170.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$289.29
|
| Rate for Payer: Vantage Medical Group Senior |
$289.29
|
|
