|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
OP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$566.23 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$382.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$471.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.49
|
| Rate for Payer: Blue Shield of California Commercial |
$384.40
|
| Rate for Payer: Blue Shield of California EPN |
$251.03
|
| Rate for Payer: Cash Price |
$346.03
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: Cigna of CA HMO |
$402.65
|
| Rate for Payer: Cigna of CA PPO |
$465.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$534.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: InnovAge PACE Commercial |
$314.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$440.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$440.40
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
| Rate for Payer: Riverside University Health System MISP |
$251.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$377.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.57
|
| Rate for Payer: United Healthcare All Other HMO |
$314.57
|
| Rate for Payer: United Healthcare HMO Rider |
$314.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.77
|
| Rate for Payer: Vantage Medical Group Senior |
$534.77
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Blue Shield of California Commercial |
$342.53
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$243.72
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.36
|
| Rate for Payer: Blue Shield of California Commercial |
$342.53
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$243.72
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: InnovAge PACE Commercial |
$221.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$310.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Riverside University Health System MISP |
$177.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Blue Shield of California Commercial |
$342.53
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$243.72
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
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 |
$319.00
|
| 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 CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$398.81 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$202.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.36
|
| Rate for Payer: Blue Shield of California Commercial |
$342.53
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$243.72
|
| Rate for Payer: Central Health Plan Commercial |
$354.50
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.81
|
| Rate for Payer: InnovAge PACE Commercial |
$221.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$310.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$332.34
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Riverside University Health System MISP |
$177.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
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 |
$319.00
|
| 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 CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| 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 |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| 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 |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.79
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| 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 |
$175.00
|
| 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 |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| 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 CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
IP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$790.74 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Blue Shield of California Commercial |
$679.16
|
| Rate for Payer: Blue Shield of California EPN |
$442.81
|
| Rate for Payer: Cash Price |
$483.23
|
| Rate for Payer: Central Health Plan Commercial |
$702.88
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.72
|
| Rate for Payer: Multiplan Commercial |
$658.95
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
|
|
HC CATH CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
OP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$790.74 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$658.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$401.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$486.48
|
| Rate for Payer: Blue Shield of California Commercial |
$679.16
|
| Rate for Payer: Blue Shield of California EPN |
$442.81
|
| Rate for Payer: Cash Price |
$483.23
|
| Rate for Payer: Central Health Plan Commercial |
$702.88
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$746.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$746.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$790.74
|
| Rate for Payer: InnovAge PACE Commercial |
$439.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$615.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$615.02
|
| Rate for Payer: Multiplan Commercial |
$658.95
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: Riverside University Health System MISP |
$351.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$746.81
|
| Rate for Payer: Vantage Medical Group Senior |
$746.81
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
IP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
OP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.09
|
| Rate for Payer: Blue Shield of California Commercial |
$4.26
|
| Rate for Payer: Blue Shield of California EPN |
$2.78
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: InnovAge PACE Commercial |
$3.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC CATH COOK CORONARY
|
Facility
|
OP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.00
|
| Rate for Payer: Blue Shield of California Commercial |
$153.97
|
| Rate for Payer: Blue Shield of California EPN |
$100.55
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: Cigna of CA HMO |
$161.28
|
| Rate for Payer: Cigna of CA PPO |
$186.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: InnovAge PACE Commercial |
$126.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$176.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Riverside University Health System MISP |
$100.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$126.00
|
| Rate for Payer: United Healthcare All Other HMO |
$126.00
|
| Rate for Payer: United Healthcare HMO Rider |
$126.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC CATH COOK CORONARY
|
Facility
|
IP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.48
|
| Rate for Payer: Blue Shield of California Commercial |
$91.01
|
| Rate for Payer: Blue Shield of California EPN |
$59.44
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: InnovAge PACE Commercial |
$74.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Riverside University Health System MISP |
$59.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH COOK POLYETHYLENE JB1
|
Facility
|
IP
|
$138.32
|
|
| Hospital Charge Code |
906812444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$124.49 |
| Rate for Payer: Adventist Health Commercial |
$27.66
|
| Rate for Payer: Cash Price |
$76.08
|
| Rate for Payer: Central Health Plan Commercial |
$110.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.33
|
| Rate for Payer: EPIC Health Plan Senior |
$55.33
|
| Rate for Payer: Galaxy Health WC |
$117.57
|
| Rate for Payer: Global Benefits Group Commercial |
$82.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.66
|
| Rate for Payer: Multiplan Commercial |
$103.74
|
| Rate for Payer: Networks By Design Commercial |
$89.91
|
| Rate for Payer: Prime Health Services Commercial |
$117.57
|
|
|
HC CATH COOK POLYETHYLENE JB1
|
Facility
|
OP
|
$138.32
|
|
| Hospital Charge Code |
906812444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$124.49 |
| Rate for Payer: Adventist Health Commercial |
$27.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$84.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.24
|
| Rate for Payer: Blue Shield of California Commercial |
$84.51
|
| Rate for Payer: Blue Shield of California EPN |
$55.19
|
| Rate for Payer: Cash Price |
$76.08
|
| Rate for Payer: Central Health Plan Commercial |
$110.66
|
| Rate for Payer: Cigna of CA HMO |
$88.52
|
| Rate for Payer: Cigna of CA PPO |
$102.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.33
|
| Rate for Payer: EPIC Health Plan Senior |
$55.33
|
| Rate for Payer: Galaxy Health WC |
$117.57
|
| Rate for Payer: Global Benefits Group Commercial |
$82.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.49
|
| Rate for Payer: InnovAge PACE Commercial |
$69.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.82
|
| Rate for Payer: Multiplan Commercial |
$103.74
|
| Rate for Payer: Networks By Design Commercial |
$89.91
|
| Rate for Payer: Prime Health Services Commercial |
$117.57
|
| Rate for Payer: Riverside University Health System MISP |
$55.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.16
|
| Rate for Payer: United Healthcare All Other HMO |
$69.16
|
| Rate for Payer: United Healthcare HMO Rider |
$69.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.57
|
| Rate for Payer: Vantage Medical Group Senior |
$117.57
|
|
|
HC CATH COOK POLYETHYLENE PED
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906812443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH COOK POLYETHYLENE PED
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906812443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.48
|
| Rate for Payer: Blue Shield of California Commercial |
$91.01
|
| Rate for Payer: Blue Shield of California EPN |
$59.44
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: InnovAge PACE Commercial |
$74.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Riverside University Health System MISP |
$59.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK RIM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
906812510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.53
|
| Rate for Payer: Blue Shield of California Commercial |
$87.30
|
| Rate for Payer: Blue Shield of California EPN |
$56.92
|
| Rate for Payer: Cash Price |
$62.12
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Cigna of CA HMO |
$79.06
|
| Rate for Payer: Cigna of CA PPO |
$79.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: InnovAge PACE Commercial |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$56.47
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Riverside University Health System MISP |
$45.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.39
|
| Rate for Payer: United Healthcare All Other HMO |
$41.26
|
| Rate for Payer: United Healthcare HMO Rider |
$40.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH COOK RIM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
906812510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Blue Shield of California Commercial |
$87.30
|
| Rate for Payer: Blue Shield of California EPN |
$56.92
|
| Rate for Payer: Cash Price |
$62.12
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Cigna of CA HMO |
$79.06
|
| Rate for Payer: Cigna of CA PPO |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$56.47
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.39
|
| Rate for Payer: United Healthcare All Other HMO |
$41.26
|
| Rate for Payer: United Healthcare HMO Rider |
$40.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.99
|
|
|
HC CATH COOK SLIP-CATH 80CM
|
Facility
|
IP
|
$389.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.89 |
| Max. Negotiated Rate |
$350.52 |
| Rate for Payer: Adventist Health Commercial |
$77.89
|
| Rate for Payer: Cash Price |
$214.21
|
| Rate for Payer: Central Health Plan Commercial |
$311.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.79
|
| Rate for Payer: EPIC Health Plan Senior |
$155.79
|
| Rate for Payer: Galaxy Health WC |
$331.05
|
| Rate for Payer: Global Benefits Group Commercial |
$233.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.89
|
| Rate for Payer: Multiplan Commercial |
$292.10
|
| Rate for Payer: Networks By Design Commercial |
$253.16
|
| Rate for Payer: Prime Health Services Commercial |
$331.05
|
|
|
HC CATH COOK SLIP-CATH 80CM
|
Facility
|
OP
|
$389.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.89 |
| Max. Negotiated Rate |
$350.52 |
| Rate for Payer: Adventist Health Commercial |
$77.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$236.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$331.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$292.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.74
|
| Rate for Payer: Blue Shield of California Commercial |
$237.97
|
| Rate for Payer: Blue Shield of California EPN |
$155.40
|
| Rate for Payer: Cash Price |
$214.21
|
| Rate for Payer: Central Health Plan Commercial |
$311.58
|
| Rate for Payer: Cigna of CA HMO |
$249.26
|
| Rate for Payer: Cigna of CA PPO |
$288.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$331.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$331.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$331.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.79
|
| Rate for Payer: EPIC Health Plan Senior |
$155.79
|
| Rate for Payer: Galaxy Health WC |
$331.05
|
| Rate for Payer: Global Benefits Group Commercial |
$233.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$350.52
|
| Rate for Payer: InnovAge PACE Commercial |
$194.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$272.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$272.63
|
| Rate for Payer: Multiplan Commercial |
$292.10
|
| Rate for Payer: Networks By Design Commercial |
$253.16
|
| Rate for Payer: Prime Health Services Commercial |
$331.05
|
| Rate for Payer: Riverside University Health System MISP |
$155.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$233.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$233.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$194.74
|
| Rate for Payer: United Healthcare All Other HMO |
$194.74
|
| Rate for Payer: United Healthcare HMO Rider |
$194.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$194.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$331.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$331.05
|
| Rate for Payer: Vantage Medical Group Senior |
$331.05
|
|
