|
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
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
IP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$263.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$239.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$222.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
OP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$228.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.30
|
| Rate for Payer: Blue Shield of California Commercial |
$239.02
|
| Rate for Payer: Blue Shield of California EPN |
$150.42
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$263.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$239.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$222.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Riverside University Health System MISP |
$150.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
OP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$284.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$272.84
|
| Rate for Payer: Blue Shield of California Commercial |
$297.37
|
| Rate for Payer: Blue Shield of California EPN |
$187.15
|
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: Cigna of CA HMO |
$300.19
|
| Rate for Payer: Cigna of CA PPO |
$347.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$398.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$398.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$398.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$328.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$170.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$328.33
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
| Rate for Payer: Riverside University Health System MISP |
$187.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$281.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.52
|
| Rate for Payer: United Healthcare All Other HMO |
$234.52
|
| Rate for Payer: United Healthcare HMO Rider |
$234.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$398.68
|
| Rate for Payer: Vantage Medical Group Senior |
$398.68
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
IP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$328.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
IP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,386.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,257.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,168.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
OP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,203.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,089.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,485.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$959.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,152.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1,255.95
|
| Rate for Payer: Blue Shield of California EPN |
$790.42
|
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: Cigna of CA HMO |
$1,267.84
|
| Rate for Payer: Cigna of CA PPO |
$1,465.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,683.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,683.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,386.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,257.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$719.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,168.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,386.70
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
| Rate for Payer: Riverside University Health System MISP |
$792.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.50
|
| Rate for Payer: United Healthcare All Other HMO |
$990.50
|
| Rate for Payer: United Healthcare HMO Rider |
$990.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,683.85
|
|
|
HC CATH EKOS US THROMBECTOMY
|
Facility
|
OP
|
$7,488.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Adventist Health Commercial |
$1,497.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,118.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,616.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,419.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,106.42
|
| Rate for Payer: Blue Shield of California Commercial |
$6,005.38
|
| Rate for Payer: Blue Shield of California EPN |
$3,773.95
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: Cigna of CA HMO |
$5,241.60
|
| Rate for Payer: Cigna of CA PPO |
$5,241.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,364.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,364.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,754.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,718.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,417.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,241.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$3,744.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
| Rate for Payer: Riverside University Health System MISP |
$2,995.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,492.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,492.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,810.25
|
| Rate for Payer: United Healthcare All Other HMO |
$2,735.37
|
| Rate for Payer: United Healthcare HMO Rider |
$2,676.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,452.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,364.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,364.80
|
|
|
HC CATH EKOS US THROMBECTOMY
|
Facility
|
IP
|
$7,488.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Adventist Health Commercial |
$1,497.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,005.38
|
| Rate for Payer: Blue Shield of California EPN |
$3,773.95
|
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: Cigna of CA HMO |
$5,241.60
|
| Rate for Payer: Cigna of CA PPO |
$5,241.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,754.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,417.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$3,744.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,810.25
|
| Rate for Payer: United Healthcare All Other HMO |
$2,735.37
|
| Rate for Payer: United Healthcare HMO Rider |
$2,676.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,452.32
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
IP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.50 |
| Max. Negotiated Rate |
$4,713.75 |
| Rate for Payer: Adventist Health Commercial |
$1,047.50
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,666.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,713.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,325.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,090.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.50
|
| Rate for Payer: Multiplan Commercial |
$3,928.12
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
OP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$4,713.75 |
| Rate for Payer: Adventist Health Commercial |
$1,047.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,880.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,928.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,536.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,046.65
|
| Rate for Payer: Blue Shield of California Commercial |
$3,320.57
|
| Rate for Payer: Blue Shield of California EPN |
$2,089.76
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| Rate for Payer: Cigna of CA HMO |
$3,352.00
|
| Rate for Payer: Cigna of CA PPO |
$3,875.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,451.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,451.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,666.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,713.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,325.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,901.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,090.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,666.25
|
| Rate for Payer: Multiplan Commercial |
$3,928.12
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,142.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,142.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,618.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,618.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,618.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,618.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,451.88
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
IP
|
$523.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.60 |
| Max. Negotiated Rate |
$470.70 |
| Rate for Payer: Adventist Health Commercial |
$104.60
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Central Health Plan Commercial |
$418.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$470.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$308.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.60
|
| Rate for Payer: Multiplan Commercial |
$392.25
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
OP
|
$523.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$104.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$287.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Cash Price |
$235.35
|
| Rate for Payer: Central Health Plan Commercial |
$418.40
|
| Rate for Payer: Cigna of CA HMO |
$334.72
|
| Rate for Payer: Cigna of CA PPO |
$387.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$444.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$444.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$444.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$470.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$308.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$366.10
|
| Rate for Payer: Multiplan Commercial |
$392.25
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
| Rate for Payer: Riverside University Health System MISP |
$209.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$313.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$261.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$444.55
|
| Rate for Payer: Vantage Medical Group Senior |
$444.55
|
|
|
HC CATHETER CHAIT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| 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 |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATHETER CHAIT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| 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 |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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 CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
IP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
OP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Shield of California Commercial |
$62.77
|
| Rate for Payer: Blue Shield of California EPN |
$39.50
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$69.30
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Riverside University Health System MISP |
$39.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.50
|
| Rate for Payer: United Healthcare All Other HMO |
$49.50
|
| Rate for Payer: United Healthcare HMO Rider |
$49.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.15
|
| Rate for Payer: Vantage Medical Group Senior |
$84.15
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Blue Shield of California Commercial |
$124.31
|
| Rate for Payer: Blue Shield of California EPN |
$78.12
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$108.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$98.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$91.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$85.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.00
|
| Rate for Payer: Blue Shield of California Commercial |
$124.31
|
| Rate for Payer: Blue Shield of California EPN |
$78.12
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$131.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$131.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$131.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$108.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$98.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$91.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$108.50
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: Riverside University Health System MISP |
$62.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$131.75
|
| Rate for Payer: Vantage Medical Group Senior |
$131.75
|
|
|
HC CATHETER, DRAINAGE, BILIARY
|
Facility
|
OP
|
$528.96
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.79 |
| Max. Negotiated Rate |
$476.06 |
| Rate for Payer: Adventist Health Commercial |
$105.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$449.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$396.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$241.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$290.08
|
| Rate for Payer: Blue Shield of California Commercial |
$424.23
|
| Rate for Payer: Blue Shield of California EPN |
$266.60
|
| Rate for Payer: Cash Price |
$238.03
|
| Rate for Payer: Central Health Plan Commercial |
$423.17
|
| Rate for Payer: Cigna of CA HMO |
$370.27
|
| Rate for Payer: Cigna of CA PPO |
$370.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$449.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$449.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$370.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.58
|
| Rate for Payer: EPIC Health Plan Senior |
$211.58
|
| Rate for Payer: Galaxy Health WC |
$449.62
|
| Rate for Payer: Global Benefits Group Commercial |
$317.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$312.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$370.27
|
| Rate for Payer: Multiplan Commercial |
$396.72
|
| Rate for Payer: Networks By Design Commercial |
$264.48
|
| Rate for Payer: Prime Health Services Commercial |
$449.62
|
| Rate for Payer: Riverside University Health System MISP |
$211.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$317.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$317.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$198.52
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$189.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$173.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$449.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.62
|
| Rate for Payer: Vantage Medical Group Senior |
$449.62
|
|
|
HC CATHETER, DRAINAGE, BILIARY
|
Facility
|
IP
|
$528.96
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.79 |
| Max. Negotiated Rate |
$476.06 |
| Rate for Payer: Adventist Health Commercial |
$105.79
|
| Rate for Payer: Blue Shield of California Commercial |
$424.23
|
| Rate for Payer: Blue Shield of California EPN |
$266.60
|
| Rate for Payer: Cash Price |
$238.03
|
| Rate for Payer: Central Health Plan Commercial |
$423.17
|
| Rate for Payer: Cigna of CA HMO |
$370.27
|
| Rate for Payer: Cigna of CA PPO |
$370.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$370.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.58
|
| Rate for Payer: EPIC Health Plan Senior |
$211.58
|
| Rate for Payer: Galaxy Health WC |
$449.62
|
| Rate for Payer: Global Benefits Group Commercial |
$317.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$312.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.79
|
| Rate for Payer: Multiplan Commercial |
$396.72
|
| Rate for Payer: Networks By Design Commercial |
$264.48
|
| Rate for Payer: Prime Health Services Commercial |
$449.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$198.52
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$189.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$173.23
|
|
|
HC CATHETER/GUIDING
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.71
|
| Rate for Payer: Blue Shield of California Commercial |
$114.12
|
| Rate for Payer: Blue Shield of California EPN |
$71.82
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$115.20
|
| Rate for Payer: Cigna of CA PPO |
$133.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Riverside University Health System MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC CATHETER/GUIDING
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$150.30 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$80.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.14
|
| Rate for Payer: Blue Shield of California Commercial |
$105.21
|
| Rate for Payer: Blue Shield of California EPN |
$66.30
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Central Health Plan Commercial |
$133.60
|
| Rate for Payer: Cigna of CA HMO |
$106.88
|
| Rate for Payer: Cigna of CA PPO |
$123.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.41
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$150.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$106.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.52
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.34
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
| Rate for Payer: Prime Health Services Medicare |
$9.90
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.34
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.40 |
| Max. Negotiated Rate |
$150.30 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Central Health Plan Commercial |
$133.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.80
|
| Rate for Payer: EPIC Health Plan Senior |
$66.80
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$150.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$106.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$98.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.40
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
|
