|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
IP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,439.45 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,897.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,721.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,599.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
OP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,490.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,032.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,312.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,576.70
|
| Rate for Payer: Blue Shield of California Commercial |
$1,718.46
|
| Rate for Payer: Blue Shield of California EPN |
$1,081.49
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: Cigna of CA HMO |
$1,734.72
|
| Rate for Payer: Cigna of CA PPO |
$2,005.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,303.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,303.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,897.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,721.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$983.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,599.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,897.35
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,084.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,626.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,626.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,355.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,355.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,355.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,355.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Senior |
$2,303.93
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,014.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$920.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$854.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$2,679.71 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,679.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$796.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,086.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$701.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$842.88
|
| Rate for Payer: Blue Shield of California Commercial |
$918.67
|
| Rate for Payer: Blue Shield of California EPN |
$578.15
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,231.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,231.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,014.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$920.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$525.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$854.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,014.30
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Riverside University Health System MISP |
$579.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$724.50
|
| Rate for Payer: United Healthcare All Other HMO |
$724.50
|
| Rate for Payer: United Healthcare HMO Rider |
$724.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,231.65
|
|
|
HC CATHETER PIONEER
|
Facility
|
OP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,450.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,393.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,990.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,867.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,646.33
|
| Rate for Payer: Blue Shield of California Commercial |
$5,064.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,187.01
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: Cigna of CA HMO |
$5,112.00
|
| Rate for Payer: Cigna of CA PPO |
$5,910.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,789.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,789.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,591.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,072.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,899.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,712.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,591.25
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
| Rate for Payer: Riverside University Health System MISP |
$3,195.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,792.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,792.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,993.75
|
| Rate for Payer: United Healthcare All Other HMO |
$3,993.75
|
| Rate for Payer: United Healthcare HMO Rider |
$3,993.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,993.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Senior |
$6,789.38
|
|
|
HC CATHETER PIONEER
|
Facility
|
IP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,591.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,072.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,712.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
IP
|
$117.04
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Adventist Health Commercial |
$23.41
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Central Health Plan Commercial |
$93.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$81.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.82
|
| Rate for Payer: EPIC Health Plan Senior |
$46.82
|
| Rate for Payer: Galaxy Health WC |
$99.48
|
| Rate for Payer: Global Benefits Group Commercial |
$70.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Multiplan Commercial |
$87.78
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.48
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
OP
|
$117.04
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Adventist Health Commercial |
$23.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$87.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.08
|
| Rate for Payer: Blue Shield of California Commercial |
$74.20
|
| Rate for Payer: Blue Shield of California EPN |
$46.70
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Central Health Plan Commercial |
$93.63
|
| Rate for Payer: Cigna of CA HMO |
$74.91
|
| Rate for Payer: Cigna of CA PPO |
$86.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$81.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.82
|
| Rate for Payer: EPIC Health Plan Senior |
$46.82
|
| Rate for Payer: Galaxy Health WC |
$99.48
|
| Rate for Payer: Global Benefits Group Commercial |
$70.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$81.93
|
| Rate for Payer: Multiplan Commercial |
$87.78
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.48
|
| Rate for Payer: Riverside University Health System MISP |
$46.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.52
|
| Rate for Payer: United Healthcare All Other HMO |
$58.52
|
| Rate for Payer: United Healthcare HMO Rider |
$58.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.48
|
| Rate for Payer: Vantage Medical Group Senior |
$99.48
|
|
|
HC CATH FOGARTY 10FR
|
Facility
|
IP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$616.86 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$479.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$435.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$404.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
|
|
HC CATH FOGARTY 10FR
|
Facility
|
OP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$376.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$331.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$398.70
|
| Rate for Payer: Blue Shield of California Commercial |
$434.54
|
| Rate for Payer: Blue Shield of California EPN |
$273.47
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: Cigna of CA HMO |
$438.66
|
| Rate for Payer: Cigna of CA PPO |
$507.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$582.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$582.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$582.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$479.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$435.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$248.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$404.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$479.78
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
| Rate for Payer: Riverside University Health System MISP |
$274.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$411.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$411.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.70
|
| Rate for Payer: United Healthcare All Other HMO |
$342.70
|
| Rate for Payer: United Healthcare HMO Rider |
$342.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$582.59
|
| Rate for Payer: Vantage Medical Group Senior |
$582.59
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
OP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$462.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$298.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.56
|
| Rate for Payer: Blue Shield of California Commercial |
$390.80
|
| Rate for Payer: Blue Shield of California EPN |
$245.94
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: Cigna of CA HMO |
$394.50
|
| Rate for Payer: Cigna of CA PPO |
$456.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$523.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$523.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$523.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$431.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$391.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$223.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$363.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$431.48
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
| Rate for Payer: Riverside University Health System MISP |
$246.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$369.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$308.20
|
| Rate for Payer: United Healthcare All Other HMO |
$308.20
|
| Rate for Payer: United Healthcare HMO Rider |
$308.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$523.94
|
| Rate for Payer: Vantage Medical Group Senior |
$523.94
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
IP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$554.76 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$431.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$391.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$363.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
|
|
HC CATH FOLEY 10FR UR METER TRAY
|
Facility
|
OP
|
$287.21
|
|
| Hospital Charge Code |
901698923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.44 |
| Max. Negotiated Rate |
$258.49 |
| Rate for Payer: Adventist Health Commercial |
$57.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.07
|
| Rate for Payer: Blue Shield of California Commercial |
$182.09
|
| Rate for Payer: Blue Shield of California EPN |
$114.60
|
| Rate for Payer: Cash Price |
$129.24
|
| Rate for Payer: Central Health Plan Commercial |
$229.77
|
| Rate for Payer: Cigna of CA HMO |
$183.81
|
| Rate for Payer: Cigna of CA PPO |
$212.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.88
|
| Rate for Payer: EPIC Health Plan Senior |
$114.88
|
| Rate for Payer: Galaxy Health WC |
$244.13
|
| Rate for Payer: Global Benefits Group Commercial |
$172.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$258.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.05
|
| Rate for Payer: Multiplan Commercial |
$215.41
|
| Rate for Payer: Networks By Design Commercial |
$186.69
|
| Rate for Payer: Prime Health Services Commercial |
$244.13
|
| Rate for Payer: Riverside University Health System MISP |
$114.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.60
|
| Rate for Payer: United Healthcare All Other HMO |
$143.60
|
| Rate for Payer: United Healthcare HMO Rider |
$143.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.13
|
| Rate for Payer: Vantage Medical Group Senior |
$244.13
|
|
|
HC CATH FOLEY 10FR UR METER TRAY
|
Facility
|
IP
|
$287.21
|
|
| Hospital Charge Code |
901698923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.44 |
| Max. Negotiated Rate |
$258.49 |
| Rate for Payer: Adventist Health Commercial |
$57.44
|
| Rate for Payer: Cash Price |
$129.24
|
| Rate for Payer: Central Health Plan Commercial |
$229.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.88
|
| Rate for Payer: EPIC Health Plan Senior |
$114.88
|
| Rate for Payer: Galaxy Health WC |
$244.13
|
| Rate for Payer: Global Benefits Group Commercial |
$172.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$258.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.44
|
| Rate for Payer: Multiplan Commercial |
$215.41
|
| Rate for Payer: Networks By Design Commercial |
$186.69
|
| Rate for Payer: Prime Health Services Commercial |
$244.13
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$79.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.79
|
| Rate for Payer: Blue Shield of California Commercial |
$17.21
|
| Rate for Payer: Blue Shield of California EPN |
$10.83
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: Cigna of CA HMO |
$17.37
|
| Rate for Payer: Cigna of CA PPO |
$20.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
| Rate for Payer: Riverside University Health System MISP |
$10.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.57
|
| Rate for Payer: United Healthcare All Other HMO |
$13.57
|
| Rate for Payer: United Healthcare HMO Rider |
$13.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.07
|
| Rate for Payer: Vantage Medical Group Senior |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$79.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.62
|
| Rate for Payer: Blue Shield of California Commercial |
$86.78
|
| Rate for Payer: Blue Shield of California EPN |
$54.62
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Central Health Plan Commercial |
$109.50
|
| Rate for Payer: Cigna of CA HMO |
$87.60
|
| Rate for Payer: Cigna of CA PPO |
$101.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$95.82
|
| Rate for Payer: Multiplan Commercial |
$102.66
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
| Rate for Payer: Riverside University Health System MISP |
$54.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.44
|
| Rate for Payer: United Healthcare All Other HMO |
$68.44
|
| Rate for Payer: United Healthcare HMO Rider |
$68.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.35
|
| Rate for Payer: Vantage Medical Group Senior |
$116.35
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.43 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Central Health Plan Commercial |
$109.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Multiplan Commercial |
$102.66
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
OP
|
$124.79
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Adventist Health Commercial |
$24.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.59
|
| Rate for Payer: Blue Shield of California Commercial |
$79.12
|
| Rate for Payer: Blue Shield of California EPN |
$49.79
|
| Rate for Payer: Cash Price |
$56.16
|
| Rate for Payer: Cash Price |
$56.16
|
| Rate for Payer: Central Health Plan Commercial |
$99.83
|
| Rate for Payer: Cigna of CA HMO |
$79.87
|
| Rate for Payer: Cigna of CA PPO |
$92.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$87.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.92
|
| Rate for Payer: EPIC Health Plan Senior |
$49.92
|
| Rate for Payer: Galaxy Health WC |
$106.07
|
| Rate for Payer: Global Benefits Group Commercial |
$74.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$73.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$87.35
|
| Rate for Payer: Multiplan Commercial |
$93.59
|
| Rate for Payer: Networks By Design Commercial |
$81.11
|
| Rate for Payer: Prime Health Services Commercial |
$106.07
|
| Rate for Payer: Riverside University Health System MISP |
$49.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.40
|
| Rate for Payer: United Healthcare All Other HMO |
$62.40
|
| Rate for Payer: United Healthcare HMO Rider |
$62.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.07
|
| Rate for Payer: Vantage Medical Group Senior |
$106.07
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
IP
|
$124.79
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Adventist Health Commercial |
$24.96
|
| Rate for Payer: Cash Price |
$56.16
|
| Rate for Payer: Central Health Plan Commercial |
$99.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$87.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.92
|
| Rate for Payer: EPIC Health Plan Senior |
$49.92
|
| Rate for Payer: Galaxy Health WC |
$106.07
|
| Rate for Payer: Global Benefits Group Commercial |
$74.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$73.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.96
|
| Rate for Payer: Multiplan Commercial |
$93.59
|
| Rate for Payer: Networks By Design Commercial |
$81.11
|
| Rate for Payer: Prime Health Services Commercial |
$106.07
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
IP
|
$104.73
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Adventist Health Commercial |
$20.95
|
| Rate for Payer: Cash Price |
$47.13
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Senior |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Networks By Design Commercial |
$68.07
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
OP
|
$104.73
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Adventist Health Commercial |
$20.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.92
|
| Rate for Payer: Blue Shield of California Commercial |
$66.40
|
| Rate for Payer: Blue Shield of California EPN |
$41.79
|
| Rate for Payer: Cash Price |
$47.13
|
| Rate for Payer: Cash Price |
$47.13
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: Cigna of CA HMO |
$67.03
|
| Rate for Payer: Cigna of CA PPO |
$77.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Senior |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$73.31
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Networks By Design Commercial |
$68.07
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
| Rate for Payer: Riverside University Health System MISP |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.37
|
| Rate for Payer: United Healthcare All Other HMO |
$52.37
|
| Rate for Payer: United Healthcare HMO Rider |
$52.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.02
|
| Rate for Payer: Vantage Medical Group Senior |
$89.02
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
IP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$117.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
OP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.86 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$138.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$89.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.78
|
| Rate for Payer: Blue Shield of California Commercial |
$117.47
|
| Rate for Payer: Blue Shield of California EPN |
$73.93
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$118.59
|
| Rate for Payer: Cigna of CA PPO |
$137.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$157.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$157.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$117.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$67.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$129.70
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Riverside University Health System MISP |
$74.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
IP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$186.54 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Central Health Plan Commercial |
$165.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.45
|
| Rate for Payer: Multiplan Commercial |
$155.45
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
|
