|
HC CATH IAB LIGHTWAVE
|
Facility
|
OP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,190.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,984.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,705.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,746.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,098.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,287.16
|
| Rate for Payer: Blue Shield of California EPN |
$1,439.39
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: Cigna of CA HMO |
$2,308.80
|
| Rate for Payer: Cigna of CA PPO |
$2,669.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,066.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,066.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,525.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,290.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,309.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,128.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,525.25
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
| Rate for Payer: Riverside University Health System MISP |
$1,443.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,164.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,164.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,803.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,803.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,803.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,803.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Senior |
$3,066.38
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
IP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,525.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,290.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,128.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
IP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,243.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
OP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,851.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,841.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,211.91
|
| Rate for Payer: Blue Shield of California Commercial |
$2,410.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,517.20
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: Cigna of CA HMO |
$2,433.60
|
| Rate for Payer: Cigna of CA PPO |
$2,813.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,232.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,380.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,243.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,661.75
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
| Rate for Payer: Riverside University Health System MISP |
$1,521.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.12
|
|
|
HC CATH INDIGO THROM
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,909.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,457.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
|
|
HC CATH INDIGO THROM
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,656.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,225.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,673.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,909.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,457.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,143.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,769.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,412.50
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
IP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Blue Shield of California Commercial |
$68.39
|
| Rate for Payer: Blue Shield of California EPN |
$42.98
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
OP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.76
|
| Rate for Payer: Blue Shield of California Commercial |
$68.39
|
| Rate for Payer: Blue Shield of California EPN |
$42.98
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$59.69
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Riverside University Health System MISP |
$34.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
OP
|
$101.46
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$91.31 |
| Rate for Payer: Adventist Health Commercial |
$20.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.02
|
| Rate for Payer: Blue Shield of California Commercial |
$64.33
|
| Rate for Payer: Blue Shield of California EPN |
$40.48
|
| Rate for Payer: Cash Price |
$45.66
|
| Rate for Payer: Central Health Plan Commercial |
$81.17
|
| Rate for Payer: Cigna of CA HMO |
$64.93
|
| Rate for Payer: Cigna of CA PPO |
$75.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.58
|
| Rate for Payer: EPIC Health Plan Senior |
$40.58
|
| Rate for Payer: Galaxy Health WC |
$86.24
|
| Rate for Payer: Global Benefits Group Commercial |
$60.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$71.02
|
| Rate for Payer: Multiplan Commercial |
$76.09
|
| Rate for Payer: Networks By Design Commercial |
$65.95
|
| Rate for Payer: Prime Health Services Commercial |
$86.24
|
| Rate for Payer: Riverside University Health System MISP |
$40.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.73
|
| Rate for Payer: United Healthcare All Other HMO |
$50.73
|
| Rate for Payer: United Healthcare HMO Rider |
$50.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.24
|
| Rate for Payer: Vantage Medical Group Senior |
$86.24
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
IP
|
$101.46
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$91.31 |
| Rate for Payer: Adventist Health Commercial |
$20.29
|
| Rate for Payer: Cash Price |
$45.66
|
| Rate for Payer: Central Health Plan Commercial |
$81.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.58
|
| Rate for Payer: EPIC Health Plan Senior |
$40.58
|
| Rate for Payer: Galaxy Health WC |
$86.24
|
| Rate for Payer: Global Benefits Group Commercial |
$60.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.29
|
| Rate for Payer: Multiplan Commercial |
$76.09
|
| Rate for Payer: Networks By Design Commercial |
$65.95
|
| Rate for Payer: Prime Health Services Commercial |
$86.24
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.86
|
| Rate for Payer: Blue Shield of California Commercial |
$2.03
|
| Rate for Payer: Blue Shield of California EPN |
$1.28
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: Cigna of CA HMO |
$2.05
|
| Rate for Payer: Cigna of CA PPO |
$2.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.24
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
| Rate for Payer: Riverside University Health System MISP |
$1.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.72
|
| Rate for Payer: Vantage Medical Group Senior |
$2.72
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,268.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,472.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 7.5FR 40CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,268.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,472.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 7FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,268.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,472.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 9FR 50ML
|
Facility
|
OP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,014.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,488.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,606.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,929.77
|
| Rate for Payer: Blue Shield of California Commercial |
$2,103.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,323.67
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: Cigna of CA HMO |
$2,123.17
|
| Rate for Payer: Cigna of CA PPO |
$2,454.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,819.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,819.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,322.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,106.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,204.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,957.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,322.22
|
| Rate for Payer: Multiplan Commercial |
$2,488.09
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,326.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.73
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,819.84
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
IP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,322.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,106.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,957.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Multiplan Commercial |
$2,488.09
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.93
|
| Rate for Payer: Blue Shield of California Commercial |
$14.09
|
| Rate for Payer: Blue Shield of California EPN |
$8.87
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$17.78
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$16.66
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$17.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Multiplan Commercial |
$16.66
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.93
|
| Rate for Payer: Blue Shield of California Commercial |
$14.09
|
| Rate for Payer: Blue Shield of California EPN |
$8.87
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$17.78
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$16.66
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$17.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Multiplan Commercial |
$16.66
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.93
|
| Rate for Payer: Blue Shield of California Commercial |
$14.09
|
| Rate for Payer: Blue Shield of California EPN |
$8.87
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$17.78
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$16.66
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
