|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
OP
|
$203.00
|
|
| Hospital Charge Code |
901698701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$172.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$111.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.22
|
| Rate for Payer: Blue Shield of California Commercial |
$124.03
|
| Rate for Payer: Blue Shield of California EPN |
$81.00
|
| Rate for Payer: Cash Price |
$111.65
|
| Rate for Payer: Central Health Plan Commercial |
$162.40
|
| Rate for Payer: Cigna of CA HMO |
$129.92
|
| Rate for Payer: Cigna of CA PPO |
$150.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$172.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$172.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$172.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: EPIC Health Plan Senior |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$182.70
|
| Rate for Payer: InnovAge PACE Commercial |
$101.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$125.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.10
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
| Rate for Payer: Riverside University Health System MISP |
$81.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.50
|
| Rate for Payer: United Healthcare All Other HMO |
$101.50
|
| Rate for Payer: United Healthcare HMO Rider |
$101.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$172.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$172.55
|
| Rate for Payer: Vantage Medical Group Senior |
$172.55
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
OP
|
$187.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$168.84 |
| Rate for Payer: Adventist Health Commercial |
$37.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$159.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$103.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$90.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.18
|
| Rate for Payer: Blue Shield of California Commercial |
$114.62
|
| Rate for Payer: Blue Shield of California EPN |
$74.85
|
| Rate for Payer: Cash Price |
$103.18
|
| Rate for Payer: Central Health Plan Commercial |
$150.08
|
| Rate for Payer: Cigna of CA HMO |
$120.06
|
| Rate for Payer: Cigna of CA PPO |
$138.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$159.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$159.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$159.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.04
|
| Rate for Payer: EPIC Health Plan Senior |
$75.04
|
| Rate for Payer: Galaxy Health WC |
$159.46
|
| Rate for Payer: Global Benefits Group Commercial |
$112.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$168.84
|
| Rate for Payer: InnovAge PACE Commercial |
$93.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$116.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$131.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$131.32
|
| Rate for Payer: Multiplan Commercial |
$140.70
|
| Rate for Payer: Networks By Design Commercial |
$121.94
|
| Rate for Payer: Prime Health Services Commercial |
$159.46
|
| Rate for Payer: Riverside University Health System MISP |
$75.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$112.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$112.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.80
|
| Rate for Payer: United Healthcare All Other HMO |
$93.80
|
| Rate for Payer: United Healthcare HMO Rider |
$93.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$159.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.46
|
| Rate for Payer: Vantage Medical Group Senior |
$159.46
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
IP
|
$187.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$168.84 |
| Rate for Payer: Adventist Health Commercial |
$37.52
|
| Rate for Payer: Cash Price |
$103.18
|
| Rate for Payer: Central Health Plan Commercial |
$150.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.04
|
| Rate for Payer: EPIC Health Plan Senior |
$75.04
|
| Rate for Payer: Galaxy Health WC |
$159.46
|
| Rate for Payer: Global Benefits Group Commercial |
$112.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$168.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$116.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.52
|
| Rate for Payer: Multiplan Commercial |
$140.70
|
| Rate for Payer: Networks By Design Commercial |
$121.94
|
| Rate for Payer: Prime Health Services Commercial |
$159.46
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Adventist Health Commercial |
$34.27
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Central Health Plan Commercial |
$137.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.54
|
| Rate for Payer: EPIC Health Plan Senior |
$68.54
|
| Rate for Payer: Galaxy Health WC |
$145.66
|
| Rate for Payer: Global Benefits Group Commercial |
$102.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.27
|
| Rate for Payer: Multiplan Commercial |
$128.52
|
| Rate for Payer: Networks By Design Commercial |
$111.38
|
| Rate for Payer: Prime Health Services Commercial |
$145.66
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Adventist Health Commercial |
$34.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$145.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$94.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$128.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.64
|
| Rate for Payer: Blue Shield of California Commercial |
$104.70
|
| Rate for Payer: Blue Shield of California EPN |
$68.37
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Central Health Plan Commercial |
$137.09
|
| Rate for Payer: Cigna of CA HMO |
$109.67
|
| Rate for Payer: Cigna of CA PPO |
$126.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$145.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$145.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$145.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.54
|
| Rate for Payer: EPIC Health Plan Senior |
$68.54
|
| Rate for Payer: Galaxy Health WC |
$145.66
|
| Rate for Payer: Global Benefits Group Commercial |
$102.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.22
|
| Rate for Payer: InnovAge PACE Commercial |
$85.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.95
|
| Rate for Payer: Multiplan Commercial |
$128.52
|
| Rate for Payer: Networks By Design Commercial |
$111.38
|
| Rate for Payer: Prime Health Services Commercial |
$145.66
|
| Rate for Payer: Riverside University Health System MISP |
$68.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.68
|
| Rate for Payer: United Healthcare All Other HMO |
$85.68
|
| Rate for Payer: United Healthcare HMO Rider |
$85.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$145.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$145.66
|
| Rate for Payer: Vantage Medical Group Senior |
$145.66
|
|
|
HC CATH ASAHI CORSAIR 150CM
|
Facility
|
IP
|
$3,881.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$3,492.90 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,000.01
|
| Rate for Payer: Blue Shield of California EPN |
$1,956.02
|
| Rate for Payer: Cash Price |
$2,134.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,104.80
|
| Rate for Payer: Cigna of CA HMO |
$2,716.70
|
| Rate for Payer: Cigna of CA PPO |
$2,716.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,492.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,402.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.20
|
| Rate for Payer: Multiplan Commercial |
$2,910.75
|
| Rate for Payer: Networks By Design Commercial |
$1,940.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,456.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,417.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,387.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,271.03
|
|
|
HC CATH ASAHI CORSAIR 150CM
|
Facility
|
OP
|
$3,881.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$3,492.90 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,134.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,910.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,772.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,148.91
|
| Rate for Payer: Blue Shield of California Commercial |
$3,000.01
|
| Rate for Payer: Blue Shield of California EPN |
$1,956.02
|
| Rate for Payer: Cash Price |
$2,134.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,104.80
|
| Rate for Payer: Cigna of CA HMO |
$2,716.70
|
| Rate for Payer: Cigna of CA PPO |
$2,716.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,298.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,298.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,492.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,940.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,402.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,716.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,716.70
|
| Rate for Payer: Multiplan Commercial |
$2,910.75
|
| Rate for Payer: Networks By Design Commercial |
$1,940.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
| Rate for Payer: Riverside University Health System MISP |
$1,552.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,328.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,328.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,456.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,417.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,387.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,271.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Senior |
$3,298.85
|
|
|
HC CATH ASAHI TORNUS
|
Facility
|
OP
|
$3,101.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$620.20 |
| Max. Negotiated Rate |
$2,790.90 |
| Rate for Payer: Adventist Health Commercial |
$620.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,883.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,705.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,325.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,501.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,821.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,894.71
|
| Rate for Payer: Blue Shield of California EPN |
$1,237.30
|
| Rate for Payer: Cash Price |
$1,705.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,480.80
|
| Rate for Payer: Cigna of CA HMO |
$1,984.64
|
| Rate for Payer: Cigna of CA PPO |
$2,294.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,635.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,635.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.40
|
| Rate for Payer: Galaxy Health WC |
$2,635.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,790.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,550.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,068.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,919.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$620.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,170.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,170.70
|
| Rate for Payer: Multiplan Commercial |
$2,325.75
|
| Rate for Payer: Networks By Design Commercial |
$2,015.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.85
|
| Rate for Payer: Riverside University Health System MISP |
$1,240.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,860.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,860.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,550.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,550.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,550.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,550.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,635.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,635.85
|
|
|
HC CATH ASAHI TORNUS
|
Facility
|
IP
|
$3,101.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$620.20 |
| Max. Negotiated Rate |
$2,790.90 |
| Rate for Payer: Adventist Health Commercial |
$620.20
|
| Rate for Payer: Cash Price |
$1,705.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,480.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.40
|
| Rate for Payer: Galaxy Health WC |
$2,635.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,790.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,068.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,919.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$620.20
|
| Rate for Payer: Multiplan Commercial |
$2,325.75
|
| Rate for Payer: Networks By Design Commercial |
$2,015.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.85
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
IP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,263.75 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Cash Price |
$2,605.62
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,932.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
OP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,263.75 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,877.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,605.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,553.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,293.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,782.33
|
| Rate for Payer: Blue Shield of California Commercial |
$2,894.61
|
| Rate for Payer: Blue Shield of California EPN |
$1,890.26
|
| Rate for Payer: Cash Price |
$2,605.62
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: Cigna of CA HMO |
$3,032.00
|
| Rate for Payer: Cigna of CA PPO |
$3,505.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,026.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,026.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: InnovAge PACE Commercial |
$2,368.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,932.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,316.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,316.25
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
| Rate for Payer: Riverside University Health System MISP |
$1,895.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,842.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,026.88
|
|
|
HC CATH ATRIUM EXPRESSWAY
|
Facility
|
IP
|
$1,840.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Adventist Health Commercial |
$368.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,472.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Senior |
$736.00
|
| Rate for Payer: Galaxy Health WC |
$1,564.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,104.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,656.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,227.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$368.00
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Networks By Design Commercial |
$1,196.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,564.00
|
|
|
HC CATH ATRIUM EXPRESSWAY
|
Facility
|
OP
|
$1,840.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Adventist Health Commercial |
$368.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,117.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,012.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,380.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$890.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,080.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,124.24
|
| Rate for Payer: Blue Shield of California EPN |
$734.16
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,472.00
|
| Rate for Payer: Cigna of CA HMO |
$1,177.60
|
| Rate for Payer: Cigna of CA PPO |
$1,361.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,564.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,564.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Senior |
$736.00
|
| Rate for Payer: Galaxy Health WC |
$1,564.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,104.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,656.00
|
| Rate for Payer: InnovAge PACE Commercial |
$920.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,227.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$368.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,288.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,288.00
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Networks By Design Commercial |
$1,196.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,564.00
|
| Rate for Payer: Riverside University Health System MISP |
$736.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,104.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,104.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$920.00
|
| Rate for Payer: United Healthcare All Other HMO |
$920.00
|
| Rate for Payer: United Healthcare HMO Rider |
$920.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$920.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,564.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,564.00
|
|
|
HC CATH BALLOON DRUG COATED
|
Facility
|
IP
|
$4,750.00
|
|
|
Service Code
|
CPT C2623
|
| Hospital Charge Code |
909081859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Adventist Health Commercial |
$950.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,671.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,394.00
|
| Rate for Payer: Cash Price |
$2,612.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,325.00
|
| Rate for Payer: Cigna of CA PPO |
$3,325.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,809.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,940.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,782.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,735.17
|
| Rate for Payer: United Healthcare HMO Rider |
$1,697.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,555.62
|
|
|
HC CATH BALLOON DRUG COATED
|
Facility
|
OP
|
$4,750.00
|
|
|
Service Code
|
CPT C2623
|
| Hospital Charge Code |
909081859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Adventist Health Commercial |
$950.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,612.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,562.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,168.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,630.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3,671.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,394.00
|
| Rate for Payer: Cash Price |
$2,612.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,325.00
|
| Rate for Payer: Cigna of CA PPO |
$3,325.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,037.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,037.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: InnovAge PACE Commercial |
$2,375.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,809.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,940.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,325.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,325.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,900.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,850.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,850.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,782.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,735.17
|
| Rate for Payer: United Healthcare HMO Rider |
$1,697.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,555.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,037.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,037.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,037.50
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$486.99
|
| Rate for Payer: Blue Shield of California EPN |
$317.52
|
| Rate for Payer: Cash Price |
$346.50
|
| Rate for Payer: Central Health Plan Commercial |
$504.00
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$472.50
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$472.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$348.83
|
| Rate for Payer: Blue Shield of California Commercial |
$486.99
|
| Rate for Payer: Blue Shield of California EPN |
$317.52
|
| Rate for Payer: Cash Price |
$346.50
|
| Rate for Payer: Central Health Plan Commercial |
$504.00
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$535.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$535.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$535.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.00
|
| Rate for Payer: InnovAge PACE Commercial |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$441.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$472.50
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: Riverside University Health System MISP |
$252.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$535.50
|
| Rate for Payer: Vantage Medical Group Senior |
$535.50
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
IP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Cash Price |
$468.05
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$516.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$638.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$412.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$499.79
|
| Rate for Payer: Blue Shield of California Commercial |
$519.96
|
| Rate for Payer: Blue Shield of California EPN |
$339.55
|
| Rate for Payer: Cash Price |
$468.05
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$723.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$723.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$723.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: InnovAge PACE Commercial |
$425.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.70
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Riverside University Health System MISP |
$340.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$723.35
|
| Rate for Payer: Vantage Medical Group Senior |
$723.35
|
|
|
HC CATH BLLN 11.5FRX200CM 7MMX3CM BILIARY
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900100284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$313.20 |
| Rate for Payer: Adventist Health Commercial |
$69.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$261.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.69
|
| Rate for Payer: Blue Shield of California Commercial |
$269.00
|
| Rate for Payer: Blue Shield of California EPN |
$175.39
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: Cigna of CA HMO |
$243.60
|
| Rate for Payer: Cigna of CA PPO |
$243.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$295.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: InnovAge PACE Commercial |
$174.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$215.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$243.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$243.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$174.00
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
| Rate for Payer: Riverside University Health System MISP |
$139.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$208.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$130.60
|
| Rate for Payer: United Healthcare All Other HMO |
$127.12
|
| Rate for Payer: United Healthcare HMO Rider |
$124.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$295.80
|
| Rate for Payer: Vantage Medical Group Senior |
$295.80
|
|
|
HC CATH BLLN 11.5FRX200CM 7MMX3CM BILIARY
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900100284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$313.20 |
| Rate for Payer: Adventist Health Commercial |
$69.60
|
| Rate for Payer: Blue Shield of California Commercial |
$269.00
|
| Rate for Payer: Blue Shield of California EPN |
$175.39
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: Cigna of CA HMO |
$243.60
|
| Rate for Payer: Cigna of CA PPO |
$243.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$215.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$174.00
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$130.60
|
| Rate for Payer: United Healthcare All Other HMO |
$127.12
|
| Rate for Payer: United Healthcare HMO Rider |
$124.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.97
|
|
|
HC CATH BLLN 8FRX240 10-12MMX5.5CM WIRE GUIDED
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900100269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$869.40 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$821.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$531.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$724.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$441.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$534.87
|
| Rate for Payer: Blue Shield of California Commercial |
$746.72
|
| Rate for Payer: Blue Shield of California EPN |
$486.86
|
| Rate for Payer: Cash Price |
$531.30
|
| Rate for Payer: Central Health Plan Commercial |
$772.80
|
| Rate for Payer: Cigna of CA HMO |
$676.20
|
| Rate for Payer: Cigna of CA PPO |
$676.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$821.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$821.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$821.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Senior |
$386.40
|
| Rate for Payer: Galaxy Health WC |
$821.10
|
| Rate for Payer: Global Benefits Group Commercial |
$579.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$869.40
|
| Rate for Payer: InnovAge PACE Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$644.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$597.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$676.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$676.20
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Networks By Design Commercial |
$483.00
|
| Rate for Payer: Prime Health Services Commercial |
$821.10
|
| Rate for Payer: Riverside University Health System MISP |
$386.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$579.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$579.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$362.54
|
| Rate for Payer: United Healthcare All Other HMO |
$352.88
|
| Rate for Payer: United Healthcare HMO Rider |
$345.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$316.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$821.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$821.10
|
| Rate for Payer: Vantage Medical Group Senior |
$821.10
|
|
|
HC CATH BLLN 8FRX240 10-12MMX5.5CM WIRE GUIDED
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
900100269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$869.40 |
| Rate for Payer: Adventist Health Commercial |
$193.20
|
| Rate for Payer: Blue Shield of California Commercial |
$746.72
|
| Rate for Payer: Blue Shield of California EPN |
$486.86
|
| Rate for Payer: Cash Price |
$531.30
|
| Rate for Payer: Central Health Plan Commercial |
$772.80
|
| Rate for Payer: Cigna of CA HMO |
$676.20
|
| Rate for Payer: Cigna of CA PPO |
$676.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Senior |
$386.40
|
| Rate for Payer: Galaxy Health WC |
$821.10
|
| Rate for Payer: Global Benefits Group Commercial |
$579.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$869.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$644.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$597.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Networks By Design Commercial |
$483.00
|
| Rate for Payer: Prime Health Services Commercial |
$821.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$362.54
|
| Rate for Payer: United Healthcare All Other HMO |
$352.88
|
| Rate for Payer: United Healthcare HMO Rider |
$345.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$316.37
|
|
|
HC CATH BLLN BAKRI PSTPRM 236539
|
Facility
|
OP
|
$998.20
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901693140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$199.64 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Adventist Health Commercial |
$199.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$848.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$549.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$748.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$455.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$552.70
|
| Rate for Payer: Blue Shield of California Commercial |
$771.61
|
| Rate for Payer: Blue Shield of California EPN |
$503.09
|
| Rate for Payer: Cash Price |
$549.01
|
| Rate for Payer: Central Health Plan Commercial |
$798.56
|
| Rate for Payer: Cigna of CA HMO |
$698.74
|
| Rate for Payer: Cigna of CA PPO |
$698.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$848.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$848.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$848.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$399.28
|
| Rate for Payer: EPIC Health Plan Senior |
$399.28
|
| Rate for Payer: Galaxy Health WC |
$848.47
|
| Rate for Payer: Global Benefits Group Commercial |
$598.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$898.38
|
| Rate for Payer: InnovAge PACE Commercial |
$499.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$665.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$617.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$698.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$698.74
|
| Rate for Payer: Multiplan Commercial |
$748.65
|
| Rate for Payer: Networks By Design Commercial |
$499.10
|
| Rate for Payer: Prime Health Services Commercial |
$848.47
|
| Rate for Payer: Riverside University Health System MISP |
$399.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$598.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$598.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$374.62
|
| Rate for Payer: United Healthcare All Other HMO |
$364.64
|
| Rate for Payer: United Healthcare HMO Rider |
$356.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$848.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$848.47
|
| Rate for Payer: Vantage Medical Group Senior |
$848.47
|
|
|
HC CATH BLLN BAKRI PSTPRM 236539
|
Facility
|
IP
|
$998.20
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901693140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$199.64 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Adventist Health Commercial |
$199.64
|
| Rate for Payer: Blue Shield of California Commercial |
$771.61
|
| Rate for Payer: Blue Shield of California EPN |
$503.09
|
| Rate for Payer: Cash Price |
$549.01
|
| Rate for Payer: Central Health Plan Commercial |
$798.56
|
| Rate for Payer: Cigna of CA HMO |
$698.74
|
| Rate for Payer: Cigna of CA PPO |
$698.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$399.28
|
| Rate for Payer: EPIC Health Plan Senior |
$399.28
|
| Rate for Payer: Galaxy Health WC |
$848.47
|
| Rate for Payer: Global Benefits Group Commercial |
$598.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$898.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$665.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$617.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Multiplan Commercial |
$748.65
|
| Rate for Payer: Networks By Design Commercial |
$499.10
|
| Rate for Payer: Prime Health Services Commercial |
$848.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$374.62
|
| Rate for Payer: United Healthcare All Other HMO |
$364.64
|
| Rate for Payer: United Healthcare HMO Rider |
$356.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
|
