|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$94.62
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Adventist Health Commercial |
$18.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$70.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.04
|
| Rate for Payer: Blue Shield of California Commercial |
$59.99
|
| Rate for Payer: Blue Shield of California EPN |
$37.75
|
| Rate for Payer: Cash Price |
$42.58
|
| Rate for Payer: Central Health Plan Commercial |
$75.70
|
| Rate for Payer: Cigna of CA HMO |
$60.56
|
| Rate for Payer: Cigna of CA PPO |
$70.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$80.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.85
|
| Rate for Payer: EPIC Health Plan Senior |
$37.85
|
| Rate for Payer: Galaxy Health WC |
$80.43
|
| Rate for Payer: Global Benefits Group Commercial |
$56.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$66.23
|
| Rate for Payer: Multiplan Commercial |
$70.97
|
| Rate for Payer: Networks By Design Commercial |
$61.50
|
| Rate for Payer: Prime Health Services Commercial |
$80.43
|
| Rate for Payer: Riverside University Health System MISP |
$37.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.31
|
| Rate for Payer: United Healthcare All Other HMO |
$47.31
|
| Rate for Payer: United Healthcare HMO Rider |
$47.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.43
|
| Rate for Payer: Vantage Medical Group Senior |
$80.43
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
IP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$334.71 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$260.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$219.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Multiplan Commercial |
$278.93
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
OP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$204.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$278.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$180.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.33
|
| Rate for Payer: Blue Shield of California Commercial |
$235.78
|
| Rate for Payer: Blue Shield of California EPN |
$148.39
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: Cigna of CA HMO |
$238.02
|
| Rate for Payer: Cigna of CA PPO |
$275.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$316.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$316.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$316.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$260.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$219.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$260.33
|
| Rate for Payer: Multiplan Commercial |
$278.93
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
| Rate for Payer: Riverside University Health System MISP |
$148.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$185.95
|
| Rate for Payer: United Healthcare All Other HMO |
$185.95
|
| Rate for Payer: United Healthcare HMO Rider |
$185.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$316.12
|
| Rate for Payer: Vantage Medical Group Senior |
$316.12
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
OP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$404.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$366.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$499.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$322.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$387.67
|
| Rate for Payer: Blue Shield of California Commercial |
$422.53
|
| Rate for Payer: Blue Shield of California EPN |
$265.91
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: Cigna of CA HMO |
$426.53
|
| Rate for Payer: Cigna of CA PPO |
$493.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$566.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$566.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$241.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$466.51
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
| Rate for Payer: Riverside University Health System MISP |
$266.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.23
|
| Rate for Payer: United Healthcare All Other HMO |
$333.23
|
| Rate for Payer: United Healthcare HMO Rider |
$333.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$333.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.48
|
| Rate for Payer: Vantage Medical Group Senior |
$566.48
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
IP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
|
|
HC CATH RESCUE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| 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 |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH RESCUE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| 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 |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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 RESCUE SUCTION OMNEOTECH
|
Facility
|
IP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Multiplan Commercial |
$280.57
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
OP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$227.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.61
|
| Rate for Payer: Blue Shield of California Commercial |
$237.18
|
| Rate for Payer: Blue Shield of California EPN |
$149.27
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: Cigna of CA HMO |
$239.42
|
| Rate for Payer: Cigna of CA PPO |
$276.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$261.87
|
| Rate for Payer: Multiplan Commercial |
$280.57
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
| Rate for Payer: Riverside University Health System MISP |
$149.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$187.05
|
| Rate for Payer: United Healthcare All Other HMO |
$187.05
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$187.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.99
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
IP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$44.05 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Central Health Plan Commercial |
$39.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.79
|
| Rate for Payer: Multiplan Commercial |
$36.71
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
OP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$44.05 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.47
|
| Rate for Payer: Blue Shield of California Commercial |
$31.03
|
| Rate for Payer: Blue Shield of California EPN |
$19.53
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Central Health Plan Commercial |
$39.16
|
| Rate for Payer: Cigna of CA HMO |
$31.33
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.27
|
| Rate for Payer: Multiplan Commercial |
$36.71
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
| Rate for Payer: Riverside University Health System MISP |
$19.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.48
|
| Rate for Payer: United Healthcare All Other HMO |
$24.48
|
| Rate for Payer: United Healthcare HMO Rider |
$24.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.61
|
| Rate for Payer: Vantage Medical Group Senior |
$41.61
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
OP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.72
|
| Rate for Payer: Blue Shield of California Commercial |
$2.96
|
| Rate for Payer: Blue Shield of California EPN |
$1.86
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Central Health Plan Commercial |
$3.74
|
| Rate for Payer: Cigna of CA HMO |
$2.99
|
| Rate for Payer: Cigna of CA PPO |
$3.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$3.50
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
| Rate for Payer: Riverside University Health System MISP |
$1.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2.33
|
| Rate for Payer: United Healthcare HMO Rider |
$2.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.97
|
| Rate for Payer: Vantage Medical Group Senior |
$3.97
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
IP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Central Health Plan Commercial |
$3.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.93
|
| Rate for Payer: Multiplan Commercial |
$3.50
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
OP
|
$4.10
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$3.69 |
| Rate for Payer: Adventist Health Commercial |
$0.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.60
|
| Rate for Payer: Blue Shield of California EPN |
$1.64
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Central Health Plan Commercial |
$3.28
|
| Rate for Payer: Cigna of CA HMO |
$2.62
|
| Rate for Payer: Cigna of CA PPO |
$3.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.64
|
| Rate for Payer: EPIC Health Plan Senior |
$1.64
|
| Rate for Payer: Galaxy Health WC |
$3.48
|
| Rate for Payer: Global Benefits Group Commercial |
$2.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.87
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.67
|
| Rate for Payer: Prime Health Services Commercial |
$3.48
|
| Rate for Payer: Riverside University Health System MISP |
$1.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.05
|
| Rate for Payer: United Healthcare All Other HMO |
$2.05
|
| Rate for Payer: United Healthcare HMO Rider |
$2.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.48
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
IP
|
$4.10
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$3.69 |
| Rate for Payer: Adventist Health Commercial |
$0.82
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Central Health Plan Commercial |
$3.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.64
|
| Rate for Payer: EPIC Health Plan Senior |
$1.64
|
| Rate for Payer: Galaxy Health WC |
$3.48
|
| Rate for Payer: Global Benefits Group Commercial |
$2.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$3.08
|
| Rate for Payer: Networks By Design Commercial |
$2.67
|
| Rate for Payer: Prime Health Services Commercial |
$3.48
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
IP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.85 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Central Health Plan Commercial |
$9.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.41
|
| Rate for Payer: Multiplan Commercial |
$9.04
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
OP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.85 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.64
|
| Rate for Payer: Blue Shield of California EPN |
$4.81
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Central Health Plan Commercial |
$9.64
|
| Rate for Payer: Cigna of CA HMO |
$7.71
|
| Rate for Payer: Cigna of CA PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$9.04
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
| Rate for Payer: Riverside University Health System MISP |
$4.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO |
$6.03
|
| Rate for Payer: United Healthcare HMO Rider |
$6.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.24
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
IP
|
$3.36
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Adventist Health Commercial |
$0.67
|
| Rate for Payer: Cash Price |
$1.51
|
| Rate for Payer: Central Health Plan Commercial |
$2.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1.34
|
| Rate for Payer: Galaxy Health WC |
$2.86
|
| Rate for Payer: Global Benefits Group Commercial |
$2.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.67
|
| Rate for Payer: Multiplan Commercial |
$2.52
|
| Rate for Payer: Networks By Design Commercial |
$2.18
|
| Rate for Payer: Prime Health Services Commercial |
$2.86
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
OP
|
$3.36
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Adventist Health Commercial |
$0.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.95
|
| Rate for Payer: Blue Shield of California Commercial |
$2.13
|
| Rate for Payer: Blue Shield of California EPN |
$1.34
|
| Rate for Payer: Cash Price |
$1.51
|
| Rate for Payer: Central Health Plan Commercial |
$2.69
|
| Rate for Payer: Cigna of CA HMO |
$2.15
|
| Rate for Payer: Cigna of CA PPO |
$2.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1.34
|
| Rate for Payer: Galaxy Health WC |
$2.86
|
| Rate for Payer: Global Benefits Group Commercial |
$2.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$2.52
|
| Rate for Payer: Networks By Design Commercial |
$2.18
|
| Rate for Payer: Prime Health Services Commercial |
$2.86
|
| Rate for Payer: Riverside University Health System MISP |
$1.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.68
|
| Rate for Payer: United Healthcare All Other HMO |
$1.68
|
| Rate for Payer: United Healthcare HMO Rider |
$1.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.86
|
| Rate for Payer: Vantage Medical Group Senior |
$2.86
|
|
|
HC CATH SELF-CATH 14FR LONG
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
901603666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Adventist Health Commercial |
$1.05
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: Central Health Plan Commercial |
$4.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Senior |
$2.10
|
| Rate for Payer: Galaxy Health WC |
$4.46
|
| Rate for Payer: Global Benefits Group Commercial |
$3.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.05
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.41
|
| Rate for Payer: Prime Health Services Commercial |
$4.46
|
|
|
HC CATH SELF-CATH 14FR LONG
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
901603666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Adventist Health Commercial |
$1.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.05
|
| Rate for Payer: Blue Shield of California Commercial |
$3.33
|
| Rate for Payer: Blue Shield of California EPN |
$2.09
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: Central Health Plan Commercial |
$4.20
|
| Rate for Payer: Cigna of CA HMO |
$3.36
|
| Rate for Payer: Cigna of CA PPO |
$3.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Senior |
$2.10
|
| Rate for Payer: Galaxy Health WC |
$4.46
|
| Rate for Payer: Global Benefits Group Commercial |
$3.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.41
|
| Rate for Payer: Prime Health Services Commercial |
$4.46
|
| Rate for Payer: Riverside University Health System MISP |
$2.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.62
|
| Rate for Payer: United Healthcare All Other HMO |
$2.62
|
| Rate for Payer: United Healthcare HMO Rider |
$2.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.46
|
| Rate for Payer: Vantage Medical Group Senior |
$4.46
|
|
|
HC CATH SELF-CATH 14FR SOFT
|
Facility
|
OP
|
$4.02
|
|
| Hospital Charge Code |
901603849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.62 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.34
|
| Rate for Payer: Blue Shield of California Commercial |
$2.55
|
| Rate for Payer: Blue Shield of California EPN |
$1.60
|
| Rate for Payer: Cash Price |
$1.81
|
| Rate for Payer: Central Health Plan Commercial |
$3.22
|
| Rate for Payer: Cigna of CA HMO |
$2.57
|
| Rate for Payer: Cigna of CA PPO |
$2.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.81
|
| Rate for Payer: Multiplan Commercial |
$3.02
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
| Rate for Payer: Riverside University Health System MISP |
$1.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.01
|
| Rate for Payer: United Healthcare All Other HMO |
$2.01
|
| Rate for Payer: United Healthcare HMO Rider |
$2.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.42
|
| Rate for Payer: Vantage Medical Group Senior |
$3.42
|
|
|
HC CATH SELF-CATH 14FR SOFT
|
Facility
|
IP
|
$4.02
|
|
| Hospital Charge Code |
901603849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.62 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Cash Price |
$1.81
|
| Rate for Payer: Central Health Plan Commercial |
$3.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$3.02
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
|
|
HC CATH SELF-CATH 16FR MENTOR
|
Facility
|
OP
|
$10.58
|
|
| Hospital Charge Code |
901603727
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.52 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.71
|
| Rate for Payer: Blue Shield of California EPN |
$4.22
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: Central Health Plan Commercial |
$8.46
|
| Rate for Payer: Cigna of CA HMO |
$6.77
|
| Rate for Payer: Cigna of CA PPO |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.41
|
| Rate for Payer: Multiplan Commercial |
$7.93
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
| Rate for Payer: Riverside University Health System MISP |
$4.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.29
|
| Rate for Payer: United Healthcare All Other HMO |
$5.29
|
| Rate for Payer: United Healthcare HMO Rider |
$5.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.99
|
|
|
HC CATH SELF-CATH 16FR MENTOR
|
Facility
|
IP
|
$10.58
|
|
| Hospital Charge Code |
901603727
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.52 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: Central Health Plan Commercial |
$8.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.93
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
|
