|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$495.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$410.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$498.33
|
| Rate for Payer: Blue Shield of California Commercial |
$695.70
|
| Rate for Payer: Blue Shield of California EPN |
$453.60
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Central Health Plan Commercial |
$720.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$765.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$765.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$810.00
|
| Rate for Payer: InnovAge PACE Commercial |
$450.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$600.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$557.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$630.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$630.00
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: Riverside University Health System MISP |
$360.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$540.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$540.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$765.00
|
| Rate for Payer: Vantage Medical Group Senior |
$765.00
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Blue Shield of California Commercial |
$695.70
|
| Rate for Payer: Blue Shield of California EPN |
$453.60
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Central Health Plan Commercial |
$720.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$600.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$557.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.00
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
OP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$2,106.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,287.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,755.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,068.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,295.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,808.82
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.36
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,989.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,989.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,170.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,448.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,638.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,638.00
|
| Rate for Payer: Multiplan Commercial |
$1,755.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: Riverside University Health System MISP |
$936.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,404.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,989.00
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
IP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$2,106.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,808.82
|
| Rate for Payer: Blue Shield of California EPN |
$1,179.36
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,448.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.00
|
| Rate for Payer: Multiplan Commercial |
$1,755.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH BP CROSSBOSS
|
Facility
|
IP
|
$3,413.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.60 |
| Max. Negotiated Rate |
$3,071.70 |
| Rate for Payer: Adventist Health Commercial |
$682.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,638.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,720.15
|
| Rate for Payer: Cash Price |
$1,535.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,730.40
|
| Rate for Payer: Cigna of CA HMO |
$2,389.10
|
| Rate for Payer: Cigna of CA PPO |
$2,389.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,365.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,365.20
|
| Rate for Payer: Galaxy Health WC |
$2,901.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,047.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,071.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,300.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,112.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$682.60
|
| Rate for Payer: Multiplan Commercial |
$2,559.75
|
| Rate for Payer: Networks By Design Commercial |
$1,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,901.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,280.90
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,219.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,117.76
|
|
|
HC CATH BP CROSSBOSS
|
Facility
|
OP
|
$3,413.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.60 |
| Max. Negotiated Rate |
$3,071.70 |
| Rate for Payer: Adventist Health Commercial |
$682.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,877.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,559.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,558.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,889.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,638.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,720.15
|
| Rate for Payer: Cash Price |
$1,535.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,730.40
|
| Rate for Payer: Cigna of CA HMO |
$2,389.10
|
| Rate for Payer: Cigna of CA PPO |
$2,389.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,901.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,901.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,365.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,365.20
|
| Rate for Payer: Galaxy Health WC |
$2,901.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,047.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,071.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,706.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,300.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,112.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$682.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,389.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,389.10
|
| Rate for Payer: Multiplan Commercial |
$2,559.75
|
| Rate for Payer: Networks By Design Commercial |
$1,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,901.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,365.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,047.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,047.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,280.90
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,219.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,117.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,901.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,901.05
|
|
|
HC CATH BRAUN MULTI TRACK 5FR
|
Facility
|
OP
|
$250.67
|
|
| Hospital Charge Code |
906812268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Adventist Health Commercial |
$50.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$121.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.22
|
| Rate for Payer: Blue Shield of California Commercial |
$153.16
|
| Rate for Payer: Blue Shield of California EPN |
$100.02
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Central Health Plan Commercial |
$200.54
|
| Rate for Payer: Cigna of CA HMO |
$160.43
|
| Rate for Payer: Cigna of CA PPO |
$185.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$213.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$213.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.27
|
| Rate for Payer: EPIC Health Plan Senior |
$100.27
|
| Rate for Payer: Galaxy Health WC |
$213.07
|
| Rate for Payer: Global Benefits Group Commercial |
$150.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.60
|
| Rate for Payer: InnovAge PACE Commercial |
$125.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$167.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$175.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$175.47
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: Networks By Design Commercial |
$162.94
|
| Rate for Payer: Prime Health Services Commercial |
$213.07
|
| Rate for Payer: Riverside University Health System MISP |
$100.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$125.33
|
| Rate for Payer: United Healthcare All Other HMO |
$125.33
|
| Rate for Payer: United Healthcare HMO Rider |
$125.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$125.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$213.07
|
| Rate for Payer: Vantage Medical Group Senior |
$213.07
|
|
|
HC CATH BRAUN MULTI TRACK 5FR
|
Facility
|
IP
|
$250.67
|
|
| Hospital Charge Code |
906812268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$225.60 |
| Rate for Payer: Adventist Health Commercial |
$50.13
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Central Health Plan Commercial |
$200.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.27
|
| Rate for Payer: EPIC Health Plan Senior |
$100.27
|
| Rate for Payer: Galaxy Health WC |
$213.07
|
| Rate for Payer: Global Benefits Group Commercial |
$150.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$167.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.13
|
| Rate for Payer: Multiplan Commercial |
$188.00
|
| Rate for Payer: Networks By Design Commercial |
$162.94
|
| Rate for Payer: Prime Health Services Commercial |
$213.07
|
|
|
HC CATH BRAUN MULTI TRACK 6FR
|
Facility
|
OP
|
$303.80
|
|
| Hospital Charge Code |
906812437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.76 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Adventist Health Commercial |
$60.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$184.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$258.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$167.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$147.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$178.42
|
| Rate for Payer: Blue Shield of California Commercial |
$185.62
|
| Rate for Payer: Blue Shield of California EPN |
$121.22
|
| Rate for Payer: Cash Price |
$136.71
|
| Rate for Payer: Central Health Plan Commercial |
$243.04
|
| Rate for Payer: Cigna of CA HMO |
$194.43
|
| Rate for Payer: Cigna of CA PPO |
$224.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$258.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$258.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.52
|
| Rate for Payer: EPIC Health Plan Senior |
$121.52
|
| Rate for Payer: Galaxy Health WC |
$258.23
|
| Rate for Payer: Global Benefits Group Commercial |
$182.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$273.42
|
| Rate for Payer: InnovAge PACE Commercial |
$151.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$212.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$212.66
|
| Rate for Payer: Multiplan Commercial |
$227.85
|
| Rate for Payer: Networks By Design Commercial |
$197.47
|
| Rate for Payer: Prime Health Services Commercial |
$258.23
|
| Rate for Payer: Riverside University Health System MISP |
$121.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$182.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$182.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.90
|
| Rate for Payer: United Healthcare All Other HMO |
$151.90
|
| Rate for Payer: United Healthcare HMO Rider |
$151.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$258.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$258.23
|
| Rate for Payer: Vantage Medical Group Senior |
$258.23
|
|
|
HC CATH BRAUN MULTI TRACK 6FR
|
Facility
|
IP
|
$303.80
|
|
| Hospital Charge Code |
906812437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.76 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Adventist Health Commercial |
$60.76
|
| Rate for Payer: Cash Price |
$136.71
|
| Rate for Payer: Central Health Plan Commercial |
$243.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.52
|
| Rate for Payer: EPIC Health Plan Senior |
$121.52
|
| Rate for Payer: Galaxy Health WC |
$258.23
|
| Rate for Payer: Global Benefits Group Commercial |
$182.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$273.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$202.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.76
|
| Rate for Payer: Multiplan Commercial |
$227.85
|
| Rate for Payer: Networks By Design Commercial |
$197.47
|
| Rate for Payer: Prime Health Services Commercial |
$258.23
|
|
|
HC CATH BROVIAC 4.2FR 90CM PEDS
|
Facility
|
IP
|
$2,535.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901603657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$2,281.50 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,959.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.64
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,028.00
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,281.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,690.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,569.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$507.00
|
| Rate for Payer: Multiplan Commercial |
$1,901.25
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
|
|
HC CATH BROVIAC 4.2FR 90CM PEDS
|
Facility
|
OP
|
$2,535.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901603657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$507.00 |
| Max. Negotiated Rate |
$2,281.50 |
| Rate for Payer: Adventist Health Commercial |
$507.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,394.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,901.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,157.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,403.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,959.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.64
|
| Rate for Payer: Cash Price |
$1,140.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,028.00
|
| Rate for Payer: Cigna of CA HMO |
$1,774.50
|
| Rate for Payer: Cigna of CA PPO |
$1,774.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,154.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,154.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,014.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,014.00
|
| Rate for Payer: Galaxy Health WC |
$2,154.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,281.50
|
| Rate for Payer: InnovAge PACE Commercial |
$1,267.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,690.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$965.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,569.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$507.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,774.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,774.50
|
| Rate for Payer: Multiplan Commercial |
$1,901.25
|
| Rate for Payer: Networks By Design Commercial |
$1,267.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,154.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,014.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,521.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$951.39
|
| Rate for Payer: United Healthcare All Other HMO |
$926.04
|
| Rate for Payer: United Healthcare HMO Rider |
$906.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$830.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,154.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,154.75
|
|
|
HC CATH BROVIAC 4.2FR WH
|
Facility
|
OP
|
$2,382.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$476.58 |
| Max. Negotiated Rate |
$2,144.61 |
| Rate for Payer: Adventist Health Commercial |
$476.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,025.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,787.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,088.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,319.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,841.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,200.98
|
| Rate for Payer: Cash Price |
$1,072.31
|
| Rate for Payer: Central Health Plan Commercial |
$1,906.32
|
| Rate for Payer: Cigna of CA HMO |
$1,668.03
|
| Rate for Payer: Cigna of CA PPO |
$1,668.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,025.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,025.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,025.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$953.16
|
| Rate for Payer: EPIC Health Plan Senior |
$953.16
|
| Rate for Payer: Galaxy Health WC |
$2,025.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,144.61
|
| Rate for Payer: InnovAge PACE Commercial |
$1,191.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,589.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,475.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,668.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,668.03
|
| Rate for Payer: Multiplan Commercial |
$1,787.17
|
| Rate for Payer: Networks By Design Commercial |
$1,191.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,025.46
|
| Rate for Payer: Riverside University Health System MISP |
$953.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,429.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$894.30
|
| Rate for Payer: United Healthcare All Other HMO |
$870.47
|
| Rate for Payer: United Healthcare HMO Rider |
$851.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$780.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,025.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,025.46
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.46
|
|
|
HC CATH BROVIAC 4.2FR WH
|
Facility
|
IP
|
$2,382.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$476.58 |
| Max. Negotiated Rate |
$2,144.61 |
| Rate for Payer: Adventist Health Commercial |
$476.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,841.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,200.98
|
| Rate for Payer: Cash Price |
$1,072.31
|
| Rate for Payer: Central Health Plan Commercial |
$1,906.32
|
| Rate for Payer: Cigna of CA HMO |
$1,668.03
|
| Rate for Payer: Cigna of CA PPO |
$1,668.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$953.16
|
| Rate for Payer: EPIC Health Plan Senior |
$953.16
|
| Rate for Payer: Galaxy Health WC |
$2,025.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,144.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,589.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,475.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.58
|
| Rate for Payer: Multiplan Commercial |
$1,787.17
|
| Rate for Payer: Networks By Design Commercial |
$1,191.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,025.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$894.30
|
| Rate for Payer: United Healthcare All Other HMO |
$870.47
|
| Rate for Payer: United Healthcare HMO Rider |
$851.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$780.40
|
|
|
HC CATH BS ACUITY DELIVERY SYS
|
Facility
|
IP
|
$3,744.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$748.80 |
| Max. Negotiated Rate |
$3,369.60 |
| Rate for Payer: Adventist Health Commercial |
$748.80
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,497.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,497.60
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,426.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,317.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
|
|
HC CATH BS ACUITY DELIVERY SYS
|
Facility
|
OP
|
$3,744.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$748.80 |
| Max. Negotiated Rate |
$3,369.60 |
| Rate for Payer: Adventist Health Commercial |
$748.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,273.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,182.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,059.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,808.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,812.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,198.85
|
| Rate for Payer: Blue Shield of California Commercial |
$2,287.58
|
| Rate for Payer: Blue Shield of California EPN |
$1,493.86
|
| Rate for Payer: Cash Price |
$1,684.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,995.20
|
| Rate for Payer: Cigna of CA HMO |
$2,396.16
|
| Rate for Payer: Cigna of CA PPO |
$2,770.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,182.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,182.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,182.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,497.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,497.60
|
| Rate for Payer: Galaxy Health WC |
$3,182.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,246.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,369.60
|
| Rate for Payer: InnovAge PACE Commercial |
$1,872.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,497.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,426.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,317.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,620.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,620.80
|
| Rate for Payer: Multiplan Commercial |
$2,808.00
|
| Rate for Payer: Networks By Design Commercial |
$2,433.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,182.40
|
| Rate for Payer: Riverside University Health System MISP |
$1,497.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,246.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,246.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,872.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,872.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,872.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,182.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,182.40
|
| Rate for Payer: Vantage Medical Group Senior |
$3,182.40
|
|
|
HC CATH BS CATH RUNWAY 125CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH BS CATH RUNWAY 125CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812485
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$213.85
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH BS MACH GUIDE
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$213.85
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH BS MACH GUIDE
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH B/S RENEGADE MICRO
|
Facility
|
OP
|
$2,106.34
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$421.27 |
| Max. Negotiated Rate |
$1,895.71 |
| Rate for Payer: Adventist Health Commercial |
$421.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,279.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,790.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,158.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,579.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,019.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,237.05
|
| Rate for Payer: Blue Shield of California Commercial |
$1,286.97
|
| Rate for Payer: Blue Shield of California EPN |
$840.43
|
| Rate for Payer: Cash Price |
$947.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,685.07
|
| Rate for Payer: Cigna of CA HMO |
$1,348.06
|
| Rate for Payer: Cigna of CA PPO |
$1,558.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,790.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,790.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,790.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$842.54
|
| Rate for Payer: EPIC Health Plan Senior |
$842.54
|
| Rate for Payer: Galaxy Health WC |
$1,790.39
|
| Rate for Payer: Global Benefits Group Commercial |
$1,263.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,895.71
|
| Rate for Payer: InnovAge PACE Commercial |
$1,053.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,404.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$802.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,303.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$421.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,474.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,474.44
|
| Rate for Payer: Multiplan Commercial |
$1,579.76
|
| Rate for Payer: Networks By Design Commercial |
$1,369.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,790.39
|
| Rate for Payer: Riverside University Health System MISP |
$842.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,263.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,263.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,053.17
|
| Rate for Payer: United Healthcare All Other HMO |
$1,053.17
|
| Rate for Payer: United Healthcare HMO Rider |
$1,053.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,053.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,790.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,790.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,790.39
|
|
|
HC CATH B/S RENEGADE MICRO
|
Facility
|
IP
|
$2,106.34
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$421.27 |
| Max. Negotiated Rate |
$1,895.71 |
| Rate for Payer: Adventist Health Commercial |
$421.27
|
| Rate for Payer: Cash Price |
$947.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,685.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$842.54
|
| Rate for Payer: EPIC Health Plan Senior |
$842.54
|
| Rate for Payer: Galaxy Health WC |
$1,790.39
|
| Rate for Payer: Global Benefits Group Commercial |
$1,263.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,895.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,404.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$802.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,303.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$421.27
|
| Rate for Payer: Multiplan Commercial |
$1,579.76
|
| Rate for Payer: Networks By Design Commercial |
$1,369.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,790.39
|
|
|
HC CATH CATALYST THROM
|
Facility
|
OP
|
$5,625.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,125.00 |
| Max. Negotiated Rate |
$5,062.50 |
| Rate for Payer: Adventist Health Commercial |
$1,125.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,781.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,093.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,218.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,568.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,114.56
|
| Rate for Payer: Blue Shield of California Commercial |
$4,348.12
|
| Rate for Payer: Blue Shield of California EPN |
$2,835.00
|
| Rate for Payer: Cash Price |
$2,531.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,500.00
|
| Rate for Payer: Cigna of CA HMO |
$3,937.50
|
| Rate for Payer: Cigna of CA PPO |
$3,937.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,781.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,781.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,781.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,250.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,250.00
|
| Rate for Payer: Galaxy Health WC |
$4,781.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,375.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,062.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,812.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,751.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,143.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,481.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,125.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,937.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,937.50
|
| Rate for Payer: Multiplan Commercial |
$4,218.75
|
| Rate for Payer: Networks By Design Commercial |
$2,812.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,781.25
|
| Rate for Payer: Riverside University Health System MISP |
$2,250.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,375.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,375.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,111.06
|
| Rate for Payer: United Healthcare All Other HMO |
$2,054.81
|
| Rate for Payer: United Healthcare HMO Rider |
$2,010.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,842.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,781.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,781.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,781.25
|
|
