|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
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 20FR 30ML LF
|
Facility
|
IP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.75
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
OP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.65
|
| Rate for Payer: Blue Shield of California Commercial |
$19.24
|
| Rate for Payer: Blue Shield of California EPN |
$12.11
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.24
|
| Rate for Payer: Multiplan Commercial |
$22.75
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Riverside University Health System MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
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 22FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
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 22FR 2WY 30C
|
Facility
|
OP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.41
|
| Rate for Payer: Blue Shield of California Commercial |
$20.07
|
| Rate for Payer: Blue Shield of California EPN |
$12.63
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Central Health Plan Commercial |
$25.32
|
| Rate for Payer: Cigna of CA HMO |
$20.26
|
| Rate for Payer: Cigna of CA PPO |
$23.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.16
|
| Rate for Payer: Multiplan Commercial |
$23.74
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
| Rate for Payer: Riverside University Health System MISP |
$12.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.82
|
| Rate for Payer: United Healthcare All Other HMO |
$15.82
|
| Rate for Payer: United Healthcare HMO Rider |
$15.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.90
|
| Rate for Payer: Vantage Medical Group Senior |
$26.90
|
|
|
HC CATH FOLEY SLCN 22FR 2WY 30C
|
Facility
|
IP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Central Health Plan Commercial |
$25.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.33
|
| Rate for Payer: Multiplan Commercial |
$23.74
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
OP
|
$39.77
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.13
|
| Rate for Payer: Blue Shield of California Commercial |
$25.21
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Riverside University Health System MISP |
$15.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
IP
|
$39.77
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
OP
|
$32.23
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.75
|
| Rate for Payer: Blue Shield of California Commercial |
$20.43
|
| Rate for Payer: Blue Shield of California EPN |
$12.86
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Central Health Plan Commercial |
$25.78
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$24.17
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Riverside University Health System MISP |
$12.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
IP
|
$32.23
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$29.01 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Central Health Plan Commercial |
$25.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.45
|
| Rate for Payer: Multiplan Commercial |
$24.17
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
IP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$51.88 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Central Health Plan Commercial |
$46.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.53
|
| Rate for Payer: Multiplan Commercial |
$43.24
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
OP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$51.88 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.54
|
| Rate for Payer: Blue Shield of California Commercial |
$36.55
|
| Rate for Payer: Blue Shield of California EPN |
$23.00
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Central Health Plan Commercial |
$46.12
|
| Rate for Payer: Cigna of CA HMO |
$36.90
|
| Rate for Payer: Cigna of CA PPO |
$42.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$40.35
|
| Rate for Payer: Multiplan Commercial |
$43.24
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
| Rate for Payer: Riverside University Health System MISP |
$23.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.82
|
| Rate for Payer: United Healthcare All Other HMO |
$28.82
|
| Rate for Payer: United Healthcare HMO Rider |
$28.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.00
|
| Rate for Payer: Vantage Medical Group Senior |
$49.00
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
OP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.70
|
| Rate for Payer: Blue Shield of California Commercial |
$19.29
|
| Rate for Payer: Blue Shield of California EPN |
$12.14
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Central Health Plan Commercial |
$24.34
|
| Rate for Payer: Cigna of CA HMO |
$19.47
|
| Rate for Payer: Cigna of CA PPO |
$22.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.29
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Riverside University Health System MISP |
$12.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.21
|
| Rate for Payer: United Healthcare All Other HMO |
$15.21
|
| Rate for Payer: United Healthcare HMO Rider |
$15.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.86
|
| Rate for Payer: Vantage Medical Group Senior |
$25.86
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
IP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$27.38 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Central Health Plan Commercial |
$24.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
IP
|
$131.48
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.30 |
| Max. Negotiated Rate |
$118.33 |
| Rate for Payer: Adventist Health Commercial |
$26.30
|
| Rate for Payer: Cash Price |
$59.17
|
| Rate for Payer: Central Health Plan Commercial |
$105.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.59
|
| Rate for Payer: EPIC Health Plan Senior |
$52.59
|
| Rate for Payer: Galaxy Health WC |
$111.76
|
| Rate for Payer: Global Benefits Group Commercial |
$78.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.30
|
| Rate for Payer: Multiplan Commercial |
$98.61
|
| Rate for Payer: Networks By Design Commercial |
$85.46
|
| Rate for Payer: Prime Health Services Commercial |
$111.76
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
OP
|
$131.48
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.30 |
| Max. Negotiated Rate |
$118.33 |
| Rate for Payer: Adventist Health Commercial |
$26.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.48
|
| Rate for Payer: Blue Shield of California Commercial |
$83.36
|
| Rate for Payer: Blue Shield of California EPN |
$52.46
|
| Rate for Payer: Cash Price |
$59.17
|
| Rate for Payer: Cash Price |
$59.17
|
| Rate for Payer: Central Health Plan Commercial |
$105.18
|
| Rate for Payer: Cigna of CA HMO |
$84.15
|
| Rate for Payer: Cigna of CA PPO |
$97.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.59
|
| Rate for Payer: EPIC Health Plan Senior |
$52.59
|
| Rate for Payer: Galaxy Health WC |
$111.76
|
| Rate for Payer: Global Benefits Group Commercial |
$78.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$92.04
|
| Rate for Payer: Multiplan Commercial |
$98.61
|
| Rate for Payer: Networks By Design Commercial |
$85.46
|
| Rate for Payer: Prime Health Services Commercial |
$111.76
|
| Rate for Payer: Riverside University Health System MISP |
$52.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$65.74
|
| Rate for Payer: United Healthcare All Other HMO |
$65.74
|
| Rate for Payer: United Healthcare HMO Rider |
$65.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.76
|
| Rate for Payer: Vantage Medical Group Senior |
$111.76
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$40.31 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$21.11
|
| Rate for Payer: Blue Shield of California EPN |
$13.28
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: Cigna of CA HMO |
$21.31
|
| Rate for Payer: Cigna of CA PPO |
$24.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$23.30
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
| Rate for Payer: Riverside University Health System MISP |
$13.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.64
|
| Rate for Payer: United Healthcare All Other HMO |
$16.64
|
| Rate for Payer: United Healthcare HMO Rider |
$16.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.30
|
| Rate for Payer: Vantage Medical Group Senior |
$28.30
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Blue Shield of California Commercial |
$479.60
|
| Rate for Payer: Blue Shield of California EPN |
$301.39
|
| Rate for Payer: Cash Price |
$269.10
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$418.60
|
| Rate for Payer: Cigna of CA PPO |
$418.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$418.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.43
|
| Rate for Payer: United Healthcare All Other HMO |
$218.45
|
| Rate for Payer: United Healthcare HMO Rider |
$213.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.84
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$273.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$327.94
|
| Rate for Payer: Blue Shield of California Commercial |
$479.60
|
| Rate for Payer: Blue Shield of California EPN |
$301.39
|
| Rate for Payer: Cash Price |
$269.10
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$418.60
|
| Rate for Payer: Cigna of CA PPO |
$418.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$508.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$508.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$508.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$418.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$217.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Riverside University Health System MISP |
$239.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.43
|
| Rate for Payer: United Healthcare All Other HMO |
$218.45
|
| Rate for Payer: United Healthcare HMO Rider |
$213.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$508.30
|
| Rate for Payer: Vantage Medical Group Senior |
$508.30
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
IP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$743.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$674.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$626.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$796.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$514.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$617.77
|
| Rate for Payer: Blue Shield of California Commercial |
$673.31
|
| Rate for Payer: Blue Shield of California EPN |
$423.74
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: Cigna of CA HMO |
$679.68
|
| Rate for Payer: Cigna of CA PPO |
$785.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$902.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$743.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$674.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$385.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$626.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$743.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
| Rate for Payer: Riverside University Health System MISP |
$424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.00
|
| Rate for Payer: United Healthcare All Other HMO |
$531.00
|
| Rate for Payer: United Healthcare HMO Rider |
$531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.70
|
| Rate for Payer: Vantage Medical Group Senior |
$902.70
|
|
