|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$12.01
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Riverside University Health System MISP |
$12.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
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: Aetna of CA HMO/PPO |
$19.57
|
| 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: 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 LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
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 LO-FRIC PRIMO 12FR
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Central Health Plan Commercial |
$10.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.74
|
| Rate for Payer: Multiplan Commercial |
$10.27
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 12FR
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.96
|
| Rate for Payer: Blue Shield of California Commercial |
$8.68
|
| Rate for Payer: Blue Shield of California EPN |
$5.46
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Central Health Plan Commercial |
$10.95
|
| Rate for Payer: Cigna of CA HMO |
$8.76
|
| Rate for Payer: Cigna of CA PPO |
$10.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$10.27
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
| Rate for Payer: Riverside University Health System MISP |
$5.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.84
|
| Rate for Payer: United Healthcare All Other HMO |
$6.84
|
| Rate for Payer: United Healthcare HMO Rider |
$6.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Vantage Medical Group Senior |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
IP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Cash Price |
$40.18
|
| Rate for Payer: Central Health Plan Commercial |
$71.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.86
|
| Rate for Payer: Multiplan Commercial |
$66.97
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
OP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.95
|
| Rate for Payer: Blue Shield of California Commercial |
$56.62
|
| Rate for Payer: Blue Shield of California EPN |
$35.63
|
| Rate for Payer: Cash Price |
$40.18
|
| Rate for Payer: Central Health Plan Commercial |
$71.44
|
| Rate for Payer: Cigna of CA HMO |
$57.15
|
| Rate for Payer: Cigna of CA PPO |
$66.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$62.51
|
| Rate for Payer: Multiplan Commercial |
$66.97
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
| Rate for Payer: Riverside University Health System MISP |
$35.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.65
|
| Rate for Payer: United Healthcare All Other HMO |
$44.65
|
| Rate for Payer: United Healthcare HMO Rider |
$44.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.91
|
| Rate for Payer: Vantage Medical Group Senior |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
OP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$22.14 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.31
|
| Rate for Payer: Blue Shield of California Commercial |
$15.60
|
| Rate for Payer: Blue Shield of California EPN |
$9.82
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: Central Health Plan Commercial |
$19.68
|
| Rate for Payer: Cigna of CA HMO |
$15.74
|
| Rate for Payer: Cigna of CA PPO |
$18.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.22
|
| Rate for Payer: Multiplan Commercial |
$18.45
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
| Rate for Payer: Riverside University Health System MISP |
$9.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.30
|
| Rate for Payer: United Healthcare All Other HMO |
$12.30
|
| Rate for Payer: United Healthcare HMO Rider |
$12.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.91
|
| Rate for Payer: Vantage Medical Group Senior |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
IP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$22.14 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: Central Health Plan Commercial |
$19.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$18.45
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.35
|
| Rate for Payer: Blue Shield of California Commercial |
$6.92
|
| Rate for Payer: Blue Shield of California EPN |
$4.35
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Riverside University Health System MISP |
$4.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$11.48
|
|
| Hospital Charge Code |
901605835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$10.33 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Cash Price |
$5.17
|
| Rate for Payer: Central Health Plan Commercial |
$9.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.59
|
| Rate for Payer: EPIC Health Plan Senior |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$9.76
|
| Rate for Payer: Global Benefits Group Commercial |
$6.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.30
|
| Rate for Payer: Multiplan Commercial |
$8.61
|
| Rate for Payer: Networks By Design Commercial |
$7.46
|
| Rate for Payer: Prime Health Services Commercial |
$9.76
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605906
|
|
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: Aetna of CA HMO/PPO |
$19.57
|
| 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: 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 LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605908
|
|
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 LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605908
|
|
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: Aetna of CA HMO/PPO |
$19.57
|
| 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: 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 LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$11.48
|
|
| Hospital Charge Code |
901605835
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$10.33 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.68
|
| Rate for Payer: Blue Shield of California Commercial |
$7.28
|
| Rate for Payer: Blue Shield of California EPN |
$4.58
|
| Rate for Payer: Cash Price |
$5.17
|
| Rate for Payer: Central Health Plan Commercial |
$9.18
|
| Rate for Payer: Cigna of CA HMO |
$7.35
|
| Rate for Payer: Cigna of CA PPO |
$8.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.59
|
| Rate for Payer: EPIC Health Plan Senior |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$9.76
|
| Rate for Payer: Global Benefits Group Commercial |
$6.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.04
|
| Rate for Payer: Multiplan Commercial |
$8.61
|
| Rate for Payer: Networks By Design Commercial |
$7.46
|
| Rate for Payer: Prime Health Services Commercial |
$9.76
|
| Rate for Payer: Riverside University Health System MISP |
$4.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.74
|
| Rate for Payer: United Healthcare All Other HMO |
$5.74
|
| Rate for Payer: United Healthcare HMO Rider |
$5.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.76
|
| Rate for Payer: Vantage Medical Group Senior |
$9.76
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.50
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$12.01
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Riverside University Health System MISP |
$12.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605906
|
|
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 LO-FRI PRIMO 14FR
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901605824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.35
|
| Rate for Payer: Blue Shield of California Commercial |
$6.92
|
| Rate for Payer: Blue Shield of California EPN |
$4.35
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Riverside University Health System MISP |
$4.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO-FRI PRIMO 14FR
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901605824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH MAGIC 3 INTMT 12FR FEMALE
|
Facility
|
OP
|
$11.07
|
|
| Hospital Charge Code |
901698146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Adventist Health Commercial |
$2.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7.02
|
| Rate for Payer: Blue Shield of California EPN |
$4.42
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.86
|
| Rate for Payer: Cigna of CA HMO |
$7.08
|
| Rate for Payer: Cigna of CA PPO |
$8.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4.43
|
| Rate for Payer: Galaxy Health WC |
$9.41
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.75
|
| Rate for Payer: Multiplan Commercial |
$8.30
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$9.41
|
| Rate for Payer: Riverside University Health System MISP |
$4.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.54
|
| Rate for Payer: United Healthcare All Other HMO |
$5.54
|
| Rate for Payer: United Healthcare HMO Rider |
$5.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.41
|
|
|
HC CATH MAGIC 3 INTMT 12FR FEMALE
|
Facility
|
IP
|
$11.07
|
|
| Hospital Charge Code |
901698146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Adventist Health Commercial |
$2.21
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4.43
|
| Rate for Payer: Galaxy Health WC |
$9.41
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Multiplan Commercial |
$8.30
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$9.41
|
|
|
HC CATH MAHURKAR 10FR 12MM DBL
|
Facility
|
OP
|
$446.89
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.38 |
| Max. Negotiated Rate |
$402.20 |
| Rate for Payer: Adventist Health Commercial |
$89.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$379.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$245.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$204.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.07
|
| Rate for Payer: Blue Shield of California Commercial |
$358.41
|
| Rate for Payer: Blue Shield of California EPN |
$225.23
|
| Rate for Payer: Cash Price |
$201.10
|
| Rate for Payer: Central Health Plan Commercial |
$357.51
|
| Rate for Payer: Cigna of CA HMO |
$312.82
|
| Rate for Payer: Cigna of CA PPO |
$312.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$379.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$379.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$312.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.76
|
| Rate for Payer: EPIC Health Plan Senior |
$178.76
|
| Rate for Payer: Galaxy Health WC |
$379.86
|
| Rate for Payer: Global Benefits Group Commercial |
$268.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$312.82
|
| Rate for Payer: Multiplan Commercial |
$335.17
|
| Rate for Payer: Networks By Design Commercial |
$223.44
|
| Rate for Payer: Prime Health Services Commercial |
$379.86
|
| Rate for Payer: Riverside University Health System MISP |
$178.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$268.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$268.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$167.72
|
| Rate for Payer: United Healthcare All Other HMO |
$163.25
|
| Rate for Payer: United Healthcare HMO Rider |
$159.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$146.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$379.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$379.86
|
| Rate for Payer: Vantage Medical Group Senior |
$379.86
|
|
