|
HC CATH EMBO TRELLIS
|
Facility
|
IP
|
$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: Cash Price |
$2,880.63
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| 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: 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: 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
|
|
|
HC CATH ERCP LONG TAPER TIP
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
900100300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$191.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$267.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$173.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$236.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$152.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$185.00
|
| Rate for Payer: Blue Shield of California Commercial |
$192.47
|
| Rate for Payer: Blue Shield of California EPN |
$125.69
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$252.00
|
| Rate for Payer: Cigna of CA HMO |
$201.60
|
| Rate for Payer: Cigna of CA PPO |
$233.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$267.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$267.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$283.50
|
| Rate for Payer: InnovAge PACE Commercial |
$157.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$220.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$220.50
|
| Rate for Payer: Multiplan Commercial |
$236.25
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
| Rate for Payer: Riverside University Health System MISP |
$126.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$157.50
|
| Rate for Payer: United Healthcare All Other HMO |
$157.50
|
| Rate for Payer: United Healthcare HMO Rider |
$157.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$267.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$267.75
|
| Rate for Payer: Vantage Medical Group Senior |
$267.75
|
|
|
HC CATH ERCP LONG TAPER TIP
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
900100300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$283.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$236.25
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
OP
|
$523.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$104.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$287.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$287.65
|
| Rate for Payer: Cash Price |
$287.65
|
| Rate for Payer: Cash Price |
$287.65
|
| Rate for Payer: Central Health Plan Commercial |
$418.40
|
| Rate for Payer: Cigna of CA HMO |
$334.72
|
| Rate for Payer: Cigna of CA PPO |
$387.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$444.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$444.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$444.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$470.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.44
|
| Rate for Payer: InnovAge PACE Commercial |
$261.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$348.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$323.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$366.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$366.10
|
| Rate for Payer: Multiplan Commercial |
$392.25
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
| Rate for Payer: Riverside University Health System MISP |
$209.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$313.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$444.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$444.55
|
| Rate for Payer: Vantage Medical Group Senior |
$444.55
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
IP
|
$523.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.60 |
| Max. Negotiated Rate |
$470.70 |
| Rate for Payer: Adventist Health Commercial |
$104.60
|
| Rate for Payer: Cash Price |
$287.65
|
| Rate for Payer: Central Health Plan Commercial |
$418.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$209.20
|
| Rate for Payer: Galaxy Health WC |
$444.55
|
| Rate for Payer: Global Benefits Group Commercial |
$313.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$470.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$348.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$323.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.60
|
| Rate for Payer: Multiplan Commercial |
$392.25
|
| Rate for Payer: Networks By Design Commercial |
$339.95
|
| Rate for Payer: Prime Health Services Commercial |
$444.55
|
|
|
HC CATHETER CHAIT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
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 |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATHETER CHAIT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
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 |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| 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: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$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 CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
IP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
OP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.14
|
| Rate for Payer: Blue Shield of California Commercial |
$60.49
|
| Rate for Payer: Blue Shield of California EPN |
$39.50
|
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: InnovAge PACE Commercial |
$49.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.30
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Riverside University Health System MISP |
$39.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.50
|
| Rate for Payer: United Healthcare All Other HMO |
$49.50
|
| Rate for Payer: United Healthcare HMO Rider |
$49.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.15
|
| Rate for Payer: Vantage Medical Group Senior |
$84.15
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Blue Shield of California Commercial |
$119.81
|
| Rate for Payer: Blue Shield of California EPN |
$78.12
|
| Rate for Payer: Cash Price |
$85.25
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$85.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.82
|
| Rate for Payer: Blue Shield of California Commercial |
$119.81
|
| Rate for Payer: Blue Shield of California EPN |
$78.12
|
| Rate for Payer: Cash Price |
$85.25
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$131.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$131.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$131.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: InnovAge PACE Commercial |
$77.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$108.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108.50
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: Riverside University Health System MISP |
$62.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$131.75
|
| Rate for Payer: Vantage Medical Group Senior |
$131.75
|
|
|
HC CATHETER, DRAINAGE, BILIARY
|
Facility
|
OP
|
$528.96
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.79 |
| Max. Negotiated Rate |
$476.06 |
| Rate for Payer: Adventist Health Commercial |
$105.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$449.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$396.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$241.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$292.89
|
| Rate for Payer: Blue Shield of California Commercial |
$408.89
|
| Rate for Payer: Blue Shield of California EPN |
$266.60
|
| Rate for Payer: Cash Price |
$290.93
|
| Rate for Payer: Central Health Plan Commercial |
$423.17
|
| Rate for Payer: Cigna of CA HMO |
$370.27
|
| Rate for Payer: Cigna of CA PPO |
$370.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$449.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$449.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.58
|
| Rate for Payer: EPIC Health Plan Senior |
$211.58
|
| Rate for Payer: Galaxy Health WC |
$449.62
|
| Rate for Payer: Global Benefits Group Commercial |
$317.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.06
|
| Rate for Payer: InnovAge PACE Commercial |
$264.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$327.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$370.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$370.27
|
| Rate for Payer: Multiplan Commercial |
$396.72
|
| Rate for Payer: Networks By Design Commercial |
$264.48
|
| Rate for Payer: Prime Health Services Commercial |
$449.62
|
| Rate for Payer: Riverside University Health System MISP |
$211.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$317.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$317.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$198.52
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$189.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$173.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$449.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.62
|
| Rate for Payer: Vantage Medical Group Senior |
$449.62
|
|
|
HC CATHETER, DRAINAGE, BILIARY
|
Facility
|
IP
|
$528.96
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$105.79 |
| Max. Negotiated Rate |
$476.06 |
| Rate for Payer: Adventist Health Commercial |
$105.79
|
| Rate for Payer: Blue Shield of California Commercial |
$408.89
|
| Rate for Payer: Blue Shield of California EPN |
$266.60
|
| Rate for Payer: Cash Price |
$290.93
|
| Rate for Payer: Central Health Plan Commercial |
$423.17
|
| Rate for Payer: Cigna of CA HMO |
$370.27
|
| Rate for Payer: Cigna of CA PPO |
$370.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.58
|
| Rate for Payer: EPIC Health Plan Senior |
$211.58
|
| Rate for Payer: Galaxy Health WC |
$449.62
|
| Rate for Payer: Global Benefits Group Commercial |
$317.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$327.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.79
|
| Rate for Payer: Multiplan Commercial |
$396.72
|
| Rate for Payer: Networks By Design Commercial |
$264.48
|
| Rate for Payer: Prime Health Services Commercial |
$449.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$198.52
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$189.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$173.23
|
|
|
HC CATHETER/GUIDING
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC CATHETER/GUIDING
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$109.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.71
|
| Rate for Payer: Blue Shield of California Commercial |
$109.98
|
| Rate for Payer: Blue Shield of California EPN |
$71.82
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$115.20
|
| Rate for Payer: Cigna of CA PPO |
$133.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: InnovAge PACE Commercial |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Riverside University Health System MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$80.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.08
|
| Rate for Payer: Blue Shield of California Commercial |
$101.37
|
| Rate for Payer: Blue Shield of California EPN |
$66.30
|
| Rate for Payer: Cash Price |
$91.85
|
| Rate for Payer: Cash Price |
$91.85
|
| Rate for Payer: Cash Price |
$91.85
|
| Rate for Payer: Central Health Plan Commercial |
$133.60
|
| Rate for Payer: Cigna of CA HMO |
$106.88
|
| Rate for Payer: Cigna of CA PPO |
$123.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.09
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$150.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.09
|
| Rate for Payer: InnovAge PACE Commercial |
$13.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.18
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.09
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
| Rate for Payer: Prime Health Services Medicare |
$9.64
|
| Rate for Payer: Riverside University Health System MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Vantage Medical Group Senior |
$9.09
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.40 |
| Max. Negotiated Rate |
$150.30 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Cash Price |
$91.85
|
| Rate for Payer: Central Health Plan Commercial |
$133.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.80
|
| Rate for Payer: EPIC Health Plan Senior |
$66.80
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$150.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.40
|
| Rate for Payer: Multiplan Commercial |
$125.25
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
OP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,439.45 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,646.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,490.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,032.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,312.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,591.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,656.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,081.49
|
| Rate for Payer: Cash Price |
$1,490.78
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: Cigna of CA HMO |
$1,734.72
|
| Rate for Payer: Cigna of CA PPO |
$2,005.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,303.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,303.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: InnovAge PACE Commercial |
$1,355.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,032.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,677.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,897.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,897.35
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,084.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,626.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,626.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,355.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,355.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,355.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,355.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Senior |
$2,303.93
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
IP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,439.45 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Cash Price |
$1,490.78
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,032.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,677.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$879.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$796.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,086.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$701.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$851.00
|
| Rate for Payer: Blue Shield of California Commercial |
$885.34
|
| Rate for Payer: Blue Shield of California EPN |
$578.15
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,231.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,231.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: InnovAge PACE Commercial |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,014.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,014.30
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Riverside University Health System MISP |
$579.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$724.50
|
| Rate for Payer: United Healthcare All Other HMO |
$724.50
|
| Rate for Payer: United Healthcare HMO Rider |
$724.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,231.65
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC CATHETER PIONEER
|
Facility
|
IP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Cash Price |
$4,393.12
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,043.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,944.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
|
|
HC CATHETER PIONEER
|
Facility
|
OP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,850.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,393.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,990.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,867.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,691.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,880.36
|
| Rate for Payer: Blue Shield of California EPN |
$3,187.01
|
| Rate for Payer: Cash Price |
$4,393.12
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: Cigna of CA HMO |
$5,112.00
|
| Rate for Payer: Cigna of CA PPO |
$5,910.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,789.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,789.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: InnovAge PACE Commercial |
$3,993.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,043.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,944.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,591.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,591.25
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
| Rate for Payer: Riverside University Health System MISP |
$3,195.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,792.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,792.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,993.75
|
| Rate for Payer: United Healthcare All Other HMO |
$3,993.75
|
| Rate for Payer: United Healthcare HMO Rider |
$3,993.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,993.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Senior |
$6,789.38
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
IP
|
$117.04
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Adventist Health Commercial |
$23.41
|
| Rate for Payer: Cash Price |
$64.37
|
| Rate for Payer: Central Health Plan Commercial |
$93.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.82
|
| Rate for Payer: EPIC Health Plan Senior |
$46.82
|
| Rate for Payer: Galaxy Health WC |
$99.48
|
| Rate for Payer: Global Benefits Group Commercial |
$70.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Multiplan Commercial |
$87.78
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.48
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
OP
|
$117.04
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Adventist Health Commercial |
$23.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$87.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.74
|
| Rate for Payer: Blue Shield of California Commercial |
$71.51
|
| Rate for Payer: Blue Shield of California EPN |
$46.70
|
| Rate for Payer: Cash Price |
$64.37
|
| Rate for Payer: Central Health Plan Commercial |
$93.63
|
| Rate for Payer: Cigna of CA HMO |
$74.91
|
| Rate for Payer: Cigna of CA PPO |
$86.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.82
|
| Rate for Payer: EPIC Health Plan Senior |
$46.82
|
| Rate for Payer: Galaxy Health WC |
$99.48
|
| Rate for Payer: Global Benefits Group Commercial |
$70.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: InnovAge PACE Commercial |
$58.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$81.93
|
| Rate for Payer: Multiplan Commercial |
$87.78
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.48
|
| Rate for Payer: Riverside University Health System MISP |
$46.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.52
|
| Rate for Payer: United Healthcare All Other HMO |
$58.52
|
| Rate for Payer: United Healthcare HMO Rider |
$58.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.48
|
| Rate for Payer: Vantage Medical Group Senior |
$99.48
|
|
