|
HC CATH DRAINAGE PLEURX PLEURAL KIT
|
Facility
|
IP
|
$2,636.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.20 |
| Max. Negotiated Rate |
$2,372.40 |
| Rate for Payer: Adventist Health Commercial |
$527.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,037.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,328.54
|
| Rate for Payer: Cash Price |
$1,449.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,108.80
|
| Rate for Payer: Cigna of CA HMO |
$1,845.20
|
| Rate for Payer: Cigna of CA PPO |
$1,845.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,054.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,054.40
|
| Rate for Payer: Galaxy Health WC |
$2,240.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,581.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,372.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,758.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,004.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,631.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$527.20
|
| Rate for Payer: Multiplan Commercial |
$1,977.00
|
| Rate for Payer: Networks By Design Commercial |
$1,318.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,240.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.29
|
| Rate for Payer: United Healthcare All Other HMO |
$962.93
|
| Rate for Payer: United Healthcare HMO Rider |
$942.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$863.29
|
|
|
HC CATH DRAINAGE PLEURX PLEURAL KIT
|
Facility
|
OP
|
$2,636.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.20 |
| Max. Negotiated Rate |
$2,372.40 |
| Rate for Payer: Adventist Health Commercial |
$527.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,449.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,977.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,203.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,459.55
|
| Rate for Payer: Blue Shield of California Commercial |
$2,037.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,328.54
|
| Rate for Payer: Cash Price |
$1,449.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,108.80
|
| Rate for Payer: Cigna of CA HMO |
$1,845.20
|
| Rate for Payer: Cigna of CA PPO |
$1,845.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,240.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,240.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,054.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,054.40
|
| Rate for Payer: Galaxy Health WC |
$2,240.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,581.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,372.40
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,758.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,004.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,631.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$527.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,845.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,845.20
|
| Rate for Payer: Multiplan Commercial |
$1,977.00
|
| Rate for Payer: Networks By Design Commercial |
$1,318.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,240.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,054.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,581.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,581.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.29
|
| Rate for Payer: United Healthcare All Other HMO |
$962.93
|
| Rate for Payer: United Healthcare HMO Rider |
$942.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$863.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,240.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,240.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,240.60
|
|
|
HC CATH DRAIN EXTERNAL
|
Facility
|
OP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Adventist Health Commercial |
$176.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$537.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$752.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$486.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$663.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$428.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$519.68
|
| Rate for Payer: Blue Shield of California Commercial |
$540.65
|
| Rate for Payer: Blue Shield of California EPN |
$353.06
|
| Rate for Payer: Cash Price |
$486.67
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: Cigna of CA HMO |
$566.31
|
| Rate for Payer: Cigna of CA PPO |
$654.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$752.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$752.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: EPIC Health Plan Senior |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: InnovAge PACE Commercial |
$442.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$590.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$547.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$619.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$619.40
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
| Rate for Payer: Riverside University Health System MISP |
$353.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$530.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$530.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$442.43
|
| Rate for Payer: United Healthcare All Other HMO |
$442.43
|
| Rate for Payer: United Healthcare HMO Rider |
$442.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$442.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$752.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.13
|
| Rate for Payer: Vantage Medical Group Senior |
$752.13
|
|
|
HC CATH DRAIN EXTERNAL
|
Facility
|
IP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Adventist Health Commercial |
$176.97
|
| Rate for Payer: Cash Price |
$486.67
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: EPIC Health Plan Senior |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$590.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$547.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
IP
|
$759.05
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.81 |
| Max. Negotiated Rate |
$683.14 |
| Rate for Payer: Adventist Health Commercial |
$151.81
|
| Rate for Payer: Blue Shield of California Commercial |
$586.75
|
| Rate for Payer: Blue Shield of California EPN |
$382.56
|
| Rate for Payer: Cash Price |
$417.48
|
| Rate for Payer: Central Health Plan Commercial |
$607.24
|
| Rate for Payer: Cigna of CA HMO |
$531.34
|
| Rate for Payer: Cigna of CA PPO |
$531.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.62
|
| Rate for Payer: EPIC Health Plan Senior |
$303.62
|
| Rate for Payer: Galaxy Health WC |
$645.19
|
| Rate for Payer: Global Benefits Group Commercial |
$455.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$506.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$469.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.81
|
| Rate for Payer: Multiplan Commercial |
$569.29
|
| Rate for Payer: Networks By Design Commercial |
$379.52
|
| Rate for Payer: Prime Health Services Commercial |
$645.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$284.87
|
| Rate for Payer: United Healthcare All Other HMO |
$277.28
|
| Rate for Payer: United Healthcare HMO Rider |
$271.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$248.59
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
OP
|
$759.05
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.81 |
| Max. Negotiated Rate |
$683.14 |
| Rate for Payer: Adventist Health Commercial |
$151.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$645.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$417.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$569.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$346.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$420.29
|
| Rate for Payer: Blue Shield of California Commercial |
$586.75
|
| Rate for Payer: Blue Shield of California EPN |
$382.56
|
| Rate for Payer: Cash Price |
$417.48
|
| Rate for Payer: Central Health Plan Commercial |
$607.24
|
| Rate for Payer: Cigna of CA HMO |
$531.34
|
| Rate for Payer: Cigna of CA PPO |
$531.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$645.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$645.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$645.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.62
|
| Rate for Payer: EPIC Health Plan Senior |
$303.62
|
| Rate for Payer: Galaxy Health WC |
$645.19
|
| Rate for Payer: Global Benefits Group Commercial |
$455.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.14
|
| Rate for Payer: InnovAge PACE Commercial |
$379.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$506.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$469.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$531.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$531.34
|
| Rate for Payer: Multiplan Commercial |
$569.29
|
| Rate for Payer: Networks By Design Commercial |
$379.52
|
| Rate for Payer: Prime Health Services Commercial |
$645.19
|
| Rate for Payer: Riverside University Health System MISP |
$303.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$455.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$455.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$284.87
|
| Rate for Payer: United Healthcare All Other HMO |
$277.28
|
| Rate for Payer: United Healthcare HMO Rider |
$271.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$248.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$645.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$645.19
|
| Rate for Payer: Vantage Medical Group Senior |
$645.19
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
IP
|
$635.77
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.15 |
| Max. Negotiated Rate |
$572.19 |
| Rate for Payer: Adventist Health Commercial |
$127.15
|
| Rate for Payer: Blue Shield of California Commercial |
$491.45
|
| Rate for Payer: Blue Shield of California EPN |
$320.43
|
| Rate for Payer: Cash Price |
$349.67
|
| Rate for Payer: Central Health Plan Commercial |
$508.62
|
| Rate for Payer: Cigna of CA HMO |
$445.04
|
| Rate for Payer: Cigna of CA PPO |
$445.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.31
|
| Rate for Payer: EPIC Health Plan Senior |
$254.31
|
| Rate for Payer: Galaxy Health WC |
$540.40
|
| Rate for Payer: Global Benefits Group Commercial |
$381.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.15
|
| Rate for Payer: Multiplan Commercial |
$476.83
|
| Rate for Payer: Networks By Design Commercial |
$317.88
|
| Rate for Payer: Prime Health Services Commercial |
$540.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.60
|
| Rate for Payer: United Healthcare All Other HMO |
$232.25
|
| Rate for Payer: United Healthcare HMO Rider |
$227.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.21
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
OP
|
$635.77
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.15 |
| Max. Negotiated Rate |
$572.19 |
| Rate for Payer: Adventist Health Commercial |
$127.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$540.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$290.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$352.03
|
| Rate for Payer: Blue Shield of California Commercial |
$491.45
|
| Rate for Payer: Blue Shield of California EPN |
$320.43
|
| Rate for Payer: Cash Price |
$349.67
|
| Rate for Payer: Central Health Plan Commercial |
$508.62
|
| Rate for Payer: Cigna of CA HMO |
$445.04
|
| Rate for Payer: Cigna of CA PPO |
$445.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$540.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$540.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$540.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.31
|
| Rate for Payer: EPIC Health Plan Senior |
$254.31
|
| Rate for Payer: Galaxy Health WC |
$540.40
|
| Rate for Payer: Global Benefits Group Commercial |
$381.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.19
|
| Rate for Payer: InnovAge PACE Commercial |
$317.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$445.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$445.04
|
| Rate for Payer: Multiplan Commercial |
$476.83
|
| Rate for Payer: Networks By Design Commercial |
$317.88
|
| Rate for Payer: Prime Health Services Commercial |
$540.40
|
| Rate for Payer: Riverside University Health System MISP |
$254.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.60
|
| Rate for Payer: United Healthcare All Other HMO |
$232.25
|
| Rate for Payer: United Healthcare HMO Rider |
$227.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$540.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$540.40
|
| Rate for Payer: Vantage Medical Group Senior |
$540.40
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
IP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Adventist Health Commercial |
$118.04
|
| Rate for Payer: Cash Price |
$324.60
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: EPIC Health Plan Senior |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$365.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Multiplan Commercial |
$442.63
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
OP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Adventist Health Commercial |
$118.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$358.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$501.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$442.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$285.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$346.61
|
| Rate for Payer: Blue Shield of California Commercial |
$360.60
|
| Rate for Payer: Blue Shield of California EPN |
$235.48
|
| Rate for Payer: Cash Price |
$324.60
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: Cigna of CA HMO |
$377.72
|
| Rate for Payer: Cigna of CA PPO |
$436.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$501.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$501.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$501.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: EPIC Health Plan Senior |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: InnovAge PACE Commercial |
$295.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$365.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.13
|
| Rate for Payer: Multiplan Commercial |
$442.63
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
| Rate for Payer: Riverside University Health System MISP |
$236.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$354.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$354.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$295.09
|
| Rate for Payer: United Healthcare All Other HMO |
$295.09
|
| Rate for Payer: United Healthcare HMO Rider |
$295.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$501.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$501.65
|
| Rate for Payer: Vantage Medical Group Senior |
$501.65
|
|
|
HC CATH DRAIN SET PNEUMOPERIC 6FR
|
Facility
|
IP
|
$604.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.89 |
| Max. Negotiated Rate |
$544.00 |
| Rate for Payer: Adventist Health Commercial |
$120.89
|
| Rate for Payer: Cash Price |
$332.44
|
| Rate for Payer: Central Health Plan Commercial |
$483.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.78
|
| Rate for Payer: EPIC Health Plan Senior |
$241.78
|
| Rate for Payer: Galaxy Health WC |
$513.77
|
| Rate for Payer: Global Benefits Group Commercial |
$362.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.89
|
| Rate for Payer: Multiplan Commercial |
$453.33
|
| Rate for Payer: Networks By Design Commercial |
$392.89
|
| Rate for Payer: Prime Health Services Commercial |
$513.77
|
|
|
HC CATH DRAIN SET PNEUMOPERIC 6FR
|
Facility
|
OP
|
$604.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698824
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.89 |
| Max. Negotiated Rate |
$544.00 |
| Rate for Payer: Adventist Health Commercial |
$120.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$367.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$513.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$332.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$292.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.99
|
| Rate for Payer: Blue Shield of California Commercial |
$369.31
|
| Rate for Payer: Blue Shield of California EPN |
$241.17
|
| Rate for Payer: Cash Price |
$332.44
|
| Rate for Payer: Central Health Plan Commercial |
$483.55
|
| Rate for Payer: Cigna of CA HMO |
$386.84
|
| Rate for Payer: Cigna of CA PPO |
$447.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$513.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$513.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$513.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.78
|
| Rate for Payer: EPIC Health Plan Senior |
$241.78
|
| Rate for Payer: Galaxy Health WC |
$513.77
|
| Rate for Payer: Global Benefits Group Commercial |
$362.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.00
|
| Rate for Payer: InnovAge PACE Commercial |
$302.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$423.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$423.11
|
| Rate for Payer: Multiplan Commercial |
$453.33
|
| Rate for Payer: Networks By Design Commercial |
$392.89
|
| Rate for Payer: Prime Health Services Commercial |
$513.77
|
| Rate for Payer: Riverside University Health System MISP |
$241.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$362.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$362.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.22
|
| Rate for Payer: United Healthcare All Other HMO |
$302.22
|
| Rate for Payer: United Healthcare HMO Rider |
$302.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$513.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$513.77
|
| Rate for Payer: Vantage Medical Group Senior |
$513.77
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
IP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Adventist Health Commercial |
$60.35
|
| Rate for Payer: Cash Price |
$165.97
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Senior |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
OP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Adventist Health Commercial |
$60.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$183.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$177.23
|
| Rate for Payer: Blue Shield of California Commercial |
$184.38
|
| Rate for Payer: Blue Shield of California EPN |
$120.41
|
| Rate for Payer: Cash Price |
$165.97
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: Cigna of CA HMO |
$193.13
|
| Rate for Payer: Cigna of CA PPO |
$223.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$256.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Senior |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: InnovAge PACE Commercial |
$150.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$211.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$211.24
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
| Rate for Payer: Riverside University Health System MISP |
$120.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.88
|
| Rate for Payer: United Healthcare All Other HMO |
$150.88
|
| Rate for Payer: United Healthcare HMO Rider |
$150.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.50
|
| Rate for Payer: Vantage Medical Group Senior |
$256.50
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
OP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$206.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$164.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$199.88
|
| Rate for Payer: Blue Shield of California Commercial |
$207.95
|
| Rate for Payer: Blue Shield of California EPN |
$135.80
|
| Rate for Payer: Cash Price |
$187.19
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: Cigna of CA HMO |
$217.82
|
| Rate for Payer: Cigna of CA PPO |
$251.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$289.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$289.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: InnovAge PACE Commercial |
$170.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$210.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$238.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$238.24
|
| Rate for Payer: Multiplan Commercial |
$255.25
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
| Rate for Payer: Riverside University Health System MISP |
$136.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$170.17
|
| Rate for Payer: United Healthcare All Other HMO |
$170.17
|
| Rate for Payer: United Healthcare HMO Rider |
$170.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$170.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$289.29
|
| Rate for Payer: Vantage Medical Group Senior |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
IP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Cash Price |
$187.19
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$210.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Multiplan Commercial |
$255.25
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
IP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
OP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$228.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$221.41
|
| Rate for Payer: Blue Shield of California Commercial |
$230.35
|
| Rate for Payer: Blue Shield of California EPN |
$150.42
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: InnovAge PACE Commercial |
$188.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Riverside University Health System MISP |
$150.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
IP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Cash Price |
$257.97
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
OP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$284.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$275.47
|
| Rate for Payer: Blue Shield of California Commercial |
$286.58
|
| Rate for Payer: Blue Shield of California EPN |
$187.15
|
| Rate for Payer: Cash Price |
$257.97
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: Cigna of CA HMO |
$300.19
|
| Rate for Payer: Cigna of CA PPO |
$347.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$398.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$398.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$398.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: InnovAge PACE Commercial |
$234.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$328.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$328.33
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
| Rate for Payer: Riverside University Health System MISP |
$187.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$281.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.52
|
| Rate for Payer: United Healthcare All Other HMO |
$234.52
|
| Rate for Payer: United Healthcare HMO Rider |
$234.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$398.68
|
| Rate for Payer: Vantage Medical Group Senior |
$398.68
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
IP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Cash Price |
$1,089.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,226.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
OP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,203.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,089.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,485.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$959.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,163.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,210.39
|
| Rate for Payer: Blue Shield of California EPN |
$790.42
|
| Rate for Payer: Cash Price |
$1,089.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: Cigna of CA HMO |
$1,267.84
|
| Rate for Payer: Cigna of CA PPO |
$1,465.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,683.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,683.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: InnovAge PACE Commercial |
$990.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,226.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,386.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,386.70
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
| Rate for Payer: Riverside University Health System MISP |
$792.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.50
|
| Rate for Payer: United Healthcare All Other HMO |
$990.50
|
| Rate for Payer: United Healthcare HMO Rider |
$990.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,683.85
|
|
|
HC CATH EKOS US THROMBECTOMY
|
Facility
|
IP
|
$7,488.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Adventist Health Commercial |
$1,497.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,788.22
|
| Rate for Payer: Blue Shield of California EPN |
$3,773.95
|
| Rate for Payer: Cash Price |
$4,118.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: Cigna of CA HMO |
$5,241.60
|
| Rate for Payer: Cigna of CA PPO |
$5,241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,994.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,852.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,635.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$3,744.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,810.25
|
| Rate for Payer: United Healthcare All Other HMO |
$2,735.37
|
| Rate for Payer: United Healthcare HMO Rider |
$2,676.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,452.32
|
|
|
HC CATH EKOS US THROMBECTOMY
|
Facility
|
OP
|
$7,488.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Adventist Health Commercial |
$1,497.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,118.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,616.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,419.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,146.11
|
| Rate for Payer: Blue Shield of California Commercial |
$5,788.22
|
| Rate for Payer: Blue Shield of California EPN |
$3,773.95
|
| Rate for Payer: Cash Price |
$4,118.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: Cigna of CA HMO |
$5,241.60
|
| Rate for Payer: Cigna of CA PPO |
$5,241.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,364.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,364.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: InnovAge PACE Commercial |
$3,744.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,994.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,852.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,635.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,241.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,241.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$3,744.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
| Rate for Payer: Riverside University Health System MISP |
$2,995.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,492.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,492.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,810.25
|
| Rate for Payer: United Healthcare All Other HMO |
$2,735.37
|
| Rate for Payer: United Healthcare HMO Rider |
$2,676.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,452.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,364.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,364.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,364.80
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
OP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.50 |
| Max. Negotiated Rate |
$4,713.75 |
| Rate for Payer: Adventist Health Commercial |
$1,047.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,180.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,880.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,928.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,536.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,075.98
|
| Rate for Payer: Blue Shield of California Commercial |
$3,200.11
|
| Rate for Payer: Blue Shield of California EPN |
$2,089.76
|
| Rate for Payer: Cash Price |
$2,880.63
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| Rate for Payer: Cigna of CA HMO |
$3,352.00
|
| Rate for Payer: Cigna of CA PPO |
$3,875.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,451.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,451.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,713.75
|
| Rate for Payer: InnovAge PACE Commercial |
$2,618.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,995.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,242.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,666.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,666.25
|
| Rate for Payer: Multiplan Commercial |
$3,928.12
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,142.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,142.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,618.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,618.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,618.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,618.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,451.88
|
|
