|
HC CATH CORDIS BERENSTEIN
|
Facility
|
IP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
OP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.34
|
| Rate for Payer: Blue Shield of California Commercial |
$83.58
|
| Rate for Payer: Blue Shield of California EPN |
$54.58
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: Cigna of CA HMO |
$87.55
|
| Rate for Payer: Cigna of CA PPO |
$101.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: InnovAge PACE Commercial |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.76
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
| Rate for Payer: Riverside University Health System MISP |
$54.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.40
|
| Rate for Payer: United Healthcare All Other HMO |
$68.40
|
| Rate for Payer: United Healthcare HMO Rider |
$68.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.28
|
| Rate for Payer: Vantage Medical Group Senior |
$116.28
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
OP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$422.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$382.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$521.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.48
|
| Rate for Payer: Blue Shield of California Commercial |
$424.96
|
| Rate for Payer: Blue Shield of California EPN |
$277.51
|
| Rate for Payer: Cash Price |
$382.54
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: Cigna of CA HMO |
$445.13
|
| Rate for Payer: Cigna of CA PPO |
$514.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$591.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$591.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$591.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: InnovAge PACE Commercial |
$347.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$430.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.86
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
| Rate for Payer: Riverside University Health System MISP |
$278.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$417.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$417.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.76
|
| Rate for Payer: United Healthcare All Other HMO |
$347.76
|
| Rate for Payer: United Healthcare HMO Rider |
$347.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$347.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$591.19
|
| Rate for Payer: Vantage Medical Group Senior |
$591.19
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
IP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Cash Price |
$382.54
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$430.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
|
|
HC CATH CORDIS PTCA VSTA BRITE IG
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
906812751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Cash Price |
$264.55
|
| Rate for Payer: Central Health Plan Commercial |
$384.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Senior |
$192.40
|
| Rate for Payer: Galaxy Health WC |
$408.85
|
| Rate for Payer: Global Benefits Group Commercial |
$288.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$432.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$320.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.20
|
| Rate for Payer: Multiplan Commercial |
$360.75
|
| Rate for Payer: Networks By Design Commercial |
$312.65
|
| Rate for Payer: Prime Health Services Commercial |
$408.85
|
|
|
HC CATH CORDIS PTCA VSTA BRITE IG
|
Facility
|
OP
|
$481.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
906812751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$292.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$360.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$232.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.49
|
| Rate for Payer: Blue Shield of California Commercial |
$293.89
|
| Rate for Payer: Blue Shield of California EPN |
$191.92
|
| Rate for Payer: Cash Price |
$264.55
|
| Rate for Payer: Central Health Plan Commercial |
$384.80
|
| Rate for Payer: Cigna of CA HMO |
$307.84
|
| Rate for Payer: Cigna of CA PPO |
$355.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$408.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$408.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Senior |
$192.40
|
| Rate for Payer: Galaxy Health WC |
$408.85
|
| Rate for Payer: Global Benefits Group Commercial |
$288.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$432.90
|
| Rate for Payer: InnovAge PACE Commercial |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$320.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$336.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$336.70
|
| Rate for Payer: Multiplan Commercial |
$360.75
|
| Rate for Payer: Networks By Design Commercial |
$312.65
|
| Rate for Payer: Prime Health Services Commercial |
$408.85
|
| Rate for Payer: Riverside University Health System MISP |
$192.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.50
|
| Rate for Payer: United Healthcare All Other HMO |
$240.50
|
| Rate for Payer: United Healthcare HMO Rider |
$240.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$408.85
|
| Rate for Payer: Vantage Medical Group Senior |
$408.85
|
|
|
HC CATH CORDIS TEMP AQUA
|
Facility
|
IP
|
$298.00
|
|
| Hospital Charge Code |
906812658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH CORDIS TEMP AQUA
|
Facility
|
OP
|
$298.00
|
|
| Hospital Charge Code |
906812658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$144.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.02
|
| Rate for Payer: Blue Shield of California Commercial |
$182.08
|
| Rate for Payer: Blue Shield of California EPN |
$118.90
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: InnovAge PACE Commercial |
$149.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Riverside University Health System MISP |
$119.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH COUDE 12FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 12FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.38
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$14.53
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: InnovAge PACE Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Riverside University Health System MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 14FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.38
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$14.53
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: InnovAge PACE Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Riverside University Health System MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 14FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 18FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 18FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.38
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$14.53
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: InnovAge PACE Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Riverside University Health System MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 20FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.38
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$14.53
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: InnovAge PACE Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Riverside University Health System MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 20FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$20.03
|
| Rate for Payer: Central Health Plan Commercial |
$29.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$27.31
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
IP
|
$38.38
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
OP
|
$38.38
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.54
|
| Rate for Payer: Blue Shield of California Commercial |
$23.45
|
| Rate for Payer: Blue Shield of California EPN |
$15.31
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: Cigna of CA HMO |
$24.56
|
| Rate for Payer: Cigna of CA PPO |
$28.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: InnovAge PACE Commercial |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
| Rate for Payer: Riverside University Health System MISP |
$15.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.19
|
| Rate for Payer: United Healthcare HMO Rider |
$19.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.62
|
| Rate for Payer: Vantage Medical Group Senior |
$32.62
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
OP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.13
|
| Rate for Payer: Blue Shield of California Commercial |
$29.26
|
| Rate for Payer: Blue Shield of California EPN |
$19.11
|
| Rate for Payer: Cash Price |
$26.34
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: Cigna of CA HMO |
$30.65
|
| Rate for Payer: Cigna of CA PPO |
$35.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: InnovAge PACE Commercial |
$23.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.52
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
| Rate for Payer: Riverside University Health System MISP |
$19.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.95
|
| Rate for Payer: United Healthcare All Other HMO |
$23.95
|
| Rate for Payer: United Healthcare HMO Rider |
$23.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.71
|
| Rate for Payer: Vantage Medical Group Senior |
$40.71
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
IP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Cash Price |
$26.34
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
OP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$530.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$423.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.30
|
| Rate for Payer: Blue Shield of California Commercial |
$534.01
|
| Rate for Payer: Blue Shield of California EPN |
$348.73
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: InnovAge PACE Commercial |
$437.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Riverside University Health System MISP |
$349.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
IP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
IP
|
$960.89
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.18 |
| Max. Negotiated Rate |
$864.80 |
| Rate for Payer: Adventist Health Commercial |
$192.18
|
| Rate for Payer: Cash Price |
$528.49
|
| Rate for Payer: Central Health Plan Commercial |
$768.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.36
|
| Rate for Payer: EPIC Health Plan Senior |
$384.36
|
| Rate for Payer: Galaxy Health WC |
$816.76
|
| Rate for Payer: Global Benefits Group Commercial |
$576.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.18
|
| Rate for Payer: Multiplan Commercial |
$720.67
|
| Rate for Payer: Networks By Design Commercial |
$624.58
|
| Rate for Payer: Prime Health Services Commercial |
$816.76
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
OP
|
$960.89
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.18 |
| Max. Negotiated Rate |
$864.80 |
| Rate for Payer: Adventist Health Commercial |
$192.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$583.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$816.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$720.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$564.33
|
| Rate for Payer: Blue Shield of California Commercial |
$587.10
|
| Rate for Payer: Blue Shield of California EPN |
$383.40
|
| Rate for Payer: Cash Price |
$528.49
|
| Rate for Payer: Central Health Plan Commercial |
$768.71
|
| Rate for Payer: Cigna of CA HMO |
$614.97
|
| Rate for Payer: Cigna of CA PPO |
$711.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$816.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$816.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$816.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.36
|
| Rate for Payer: EPIC Health Plan Senior |
$384.36
|
| Rate for Payer: Galaxy Health WC |
$816.76
|
| Rate for Payer: Global Benefits Group Commercial |
$576.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$864.80
|
| Rate for Payer: InnovAge PACE Commercial |
$480.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$640.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$672.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$672.62
|
| Rate for Payer: Multiplan Commercial |
$720.67
|
| Rate for Payer: Networks By Design Commercial |
$624.58
|
| Rate for Payer: Prime Health Services Commercial |
$816.76
|
| Rate for Payer: Riverside University Health System MISP |
$384.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.44
|
| Rate for Payer: United Healthcare All Other HMO |
$480.44
|
| Rate for Payer: United Healthcare HMO Rider |
$480.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$816.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$816.76
|
| Rate for Payer: Vantage Medical Group Senior |
$816.76
|
|
|
HC CATH CV 7FR 6" TL FULL TRAY
|
Facility
|
IP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Adventist Health Commercial |
$121.10
|
| Rate for Payer: Blue Shield of California Commercial |
$468.05
|
| Rate for Payer: Blue Shield of California EPN |
$305.17
|
| Rate for Payer: Cash Price |
$333.03
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Senior |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.67
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.24
|
| Rate for Payer: United Healthcare All Other HMO |
$221.19
|
| Rate for Payer: United Healthcare HMO Rider |
$216.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.30
|
|
