|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.28
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
IP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$35.72 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Central Health Plan Commercial |
$31.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.94
|
| Rate for Payer: Multiplan Commercial |
$29.77
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
OP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$79.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.09
|
| Rate for Payer: Blue Shield of California Commercial |
$25.16
|
| Rate for Payer: Blue Shield of California EPN |
$15.84
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Central Health Plan Commercial |
$31.75
|
| Rate for Payer: Cigna of CA HMO |
$25.40
|
| Rate for Payer: Cigna of CA PPO |
$29.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.78
|
| Rate for Payer: Multiplan Commercial |
$29.77
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
| Rate for Payer: Riverside University Health System MISP |
$15.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.84
|
| Rate for Payer: United Healthcare All Other HMO |
$19.84
|
| Rate for Payer: United Healthcare HMO Rider |
$19.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.74
|
| Rate for Payer: Vantage Medical Group Senior |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.28
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.28
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
IP
|
$25.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$22.88 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Central Health Plan Commercial |
$20.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.17
|
| Rate for Payer: EPIC Health Plan Senior |
$10.17
|
| Rate for Payer: Galaxy Health WC |
$21.61
|
| Rate for Payer: Global Benefits Group Commercial |
$15.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
| Rate for Payer: Networks By Design Commercial |
$16.52
|
| Rate for Payer: Prime Health Services Commercial |
$21.61
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
OP
|
$25.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.79
|
| Rate for Payer: Blue Shield of California Commercial |
$16.12
|
| Rate for Payer: Blue Shield of California EPN |
$10.14
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Central Health Plan Commercial |
$20.34
|
| Rate for Payer: Cigna of CA HMO |
$16.27
|
| Rate for Payer: Cigna of CA PPO |
$18.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.17
|
| Rate for Payer: EPIC Health Plan Senior |
$10.17
|
| Rate for Payer: Galaxy Health WC |
$21.61
|
| Rate for Payer: Global Benefits Group Commercial |
$15.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.79
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
| Rate for Payer: Networks By Design Commercial |
$16.52
|
| Rate for Payer: Prime Health Services Commercial |
$21.61
|
| Rate for Payer: Riverside University Health System MISP |
$10.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.71
|
| Rate for Payer: United Healthcare All Other HMO |
$12.71
|
| Rate for Payer: United Healthcare HMO Rider |
$12.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.61
|
| Rate for Payer: Vantage Medical Group Senior |
$21.61
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.88
|
| Rate for Payer: Blue Shield of California Commercial |
$16.22
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Cigna of CA HMO |
$16.37
|
| Rate for Payer: Cigna of CA PPO |
$18.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.91
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare HMO Rider |
$12.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.74
|
| Rate for Payer: Vantage Medical Group Senior |
$21.74
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.88
|
| Rate for Payer: Blue Shield of California Commercial |
$16.22
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Cigna of CA HMO |
$16.37
|
| Rate for Payer: Cigna of CA PPO |
$18.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.91
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare HMO Rider |
$12.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.74
|
| Rate for Payer: Vantage Medical Group Senior |
$21.74
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
OP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.74
|
| Rate for Payer: Blue Shield of California Commercial |
$19.34
|
| Rate for Payer: Blue Shield of California EPN |
$12.17
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.35
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
| Rate for Payer: Riverside University Health System MISP |
$12.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
IP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
OP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$63.32 |
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.93
|
| Rate for Payer: Blue Shield of California Commercial |
$44.61
|
| Rate for Payer: Blue Shield of California EPN |
$28.07
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Central Health Plan Commercial |
$56.29
|
| Rate for Payer: Cigna of CA HMO |
$45.03
|
| Rate for Payer: Cigna of CA PPO |
$52.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$49.25
|
| Rate for Payer: Multiplan Commercial |
$52.77
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
| Rate for Payer: Riverside University Health System MISP |
$28.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.18
|
| Rate for Payer: United Healthcare All Other HMO |
$35.18
|
| Rate for Payer: United Healthcare HMO Rider |
$35.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.81
|
| Rate for Payer: Vantage Medical Group Senior |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
IP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$63.32 |
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Central Health Plan Commercial |
$56.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.07
|
| Rate for Payer: Multiplan Commercial |
$52.77
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
IP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Central Health Plan Commercial |
$89.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Multiplan Commercial |
$83.73
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
OP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.94
|
| Rate for Payer: Blue Shield of California Commercial |
$70.78
|
| Rate for Payer: Blue Shield of California EPN |
$44.54
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Central Health Plan Commercial |
$89.31
|
| Rate for Payer: Cigna of CA HMO |
$71.45
|
| Rate for Payer: Cigna of CA PPO |
$82.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$78.15
|
| Rate for Payer: Multiplan Commercial |
$83.73
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
| Rate for Payer: Riverside University Health System MISP |
$44.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.82
|
| Rate for Payer: United Healthcare All Other HMO |
$55.82
|
| Rate for Payer: United Healthcare HMO Rider |
$55.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.89
|
| Rate for Payer: Vantage Medical Group Senior |
$94.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
OP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.98
|
| Rate for Payer: Blue Shield of California Commercial |
$16.33
|
| Rate for Payer: Blue Shield of California EPN |
$10.27
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Riverside University Health System MISP |
$10.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
IP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
OP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.86
|
| Rate for Payer: Blue Shield of California Commercial |
$33.63
|
| Rate for Payer: Blue Shield of California EPN |
$21.17
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Central Health Plan Commercial |
$42.44
|
| Rate for Payer: Cigna of CA HMO |
$33.95
|
| Rate for Payer: Cigna of CA PPO |
$39.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$37.13
|
| Rate for Payer: Multiplan Commercial |
$39.79
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
| Rate for Payer: Riverside University Health System MISP |
$21.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.52
|
| Rate for Payer: United Healthcare All Other HMO |
$26.52
|
| Rate for Payer: United Healthcare HMO Rider |
$26.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.09
|
| Rate for Payer: Vantage Medical Group Senior |
$45.09
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
IP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Central Health Plan Commercial |
$42.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.61
|
| Rate for Payer: Multiplan Commercial |
$39.79
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.88
|
| Rate for Payer: Blue Shield of California Commercial |
$16.22
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Cigna of CA HMO |
$16.37
|
| Rate for Payer: Cigna of CA PPO |
$18.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.91
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare HMO Rider |
$12.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.74
|
| Rate for Payer: Vantage Medical Group Senior |
$21.74
|
|
