|
HC CATH FOGARTY 10FR
|
Facility
|
OP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$616.86 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$376.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$331.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$402.54
|
| Rate for Payer: Blue Shield of California Commercial |
$418.78
|
| Rate for Payer: Blue Shield of California EPN |
$273.47
|
| Rate for Payer: Cash Price |
$376.97
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: Cigna of CA HMO |
$438.66
|
| Rate for Payer: Cigna of CA PPO |
$507.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$582.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$582.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$582.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: InnovAge PACE Commercial |
$342.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$424.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$479.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$479.78
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
| Rate for Payer: Riverside University Health System MISP |
$274.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$411.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$411.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.70
|
| Rate for Payer: United Healthcare All Other HMO |
$342.70
|
| Rate for Payer: United Healthcare HMO Rider |
$342.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$582.59
|
| Rate for Payer: Vantage Medical Group Senior |
$582.59
|
|
|
HC CATH FOGARTY 10FR
|
Facility
|
IP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$616.86 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Cash Price |
$376.97
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$424.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
IP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$554.76 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Cash Price |
$339.02
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
OP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$554.76 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$374.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$462.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$298.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$362.01
|
| Rate for Payer: Blue Shield of California Commercial |
$376.62
|
| Rate for Payer: Blue Shield of California EPN |
$245.94
|
| Rate for Payer: Cash Price |
$339.02
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: Cigna of CA HMO |
$394.50
|
| Rate for Payer: Cigna of CA PPO |
$456.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$523.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$523.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$523.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: InnovAge PACE Commercial |
$308.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$431.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$431.48
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
| Rate for Payer: Riverside University Health System MISP |
$246.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$369.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$308.20
|
| Rate for Payer: United Healthcare All Other HMO |
$308.20
|
| Rate for Payer: United Healthcare HMO Rider |
$308.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$523.94
|
| Rate for Payer: Vantage Medical Group Senior |
$523.94
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.39
|
| Rate for Payer: Blue Shield of California Commercial |
$83.63
|
| Rate for Payer: Blue Shield of California EPN |
$54.62
|
| Rate for Payer: Cash Price |
$75.28
|
| Rate for Payer: Central Health Plan Commercial |
$109.50
|
| Rate for Payer: Cigna of CA HMO |
$87.60
|
| Rate for Payer: Cigna of CA PPO |
$101.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.19
|
| Rate for Payer: InnovAge PACE Commercial |
$68.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.82
|
| Rate for Payer: Multiplan Commercial |
$102.66
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
| Rate for Payer: Riverside University Health System MISP |
$54.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.44
|
| Rate for Payer: United Healthcare All Other HMO |
$68.44
|
| Rate for Payer: United Healthcare HMO Rider |
$68.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.35
|
| Rate for Payer: Vantage Medical Group Senior |
$116.35
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.43 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Cash Price |
$14.93
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.43 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.94
|
| Rate for Payer: Blue Shield of California Commercial |
$16.58
|
| Rate for Payer: Blue Shield of California EPN |
$10.83
|
| Rate for Payer: Cash Price |
$14.93
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: Cigna of CA HMO |
$17.37
|
| Rate for Payer: Cigna of CA PPO |
$20.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: InnovAge PACE Commercial |
$13.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
| Rate for Payer: Riverside University Health System MISP |
$10.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.57
|
| Rate for Payer: United Healthcare All Other HMO |
$13.57
|
| Rate for Payer: United Healthcare HMO Rider |
$13.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.07
|
| Rate for Payer: Vantage Medical Group Senior |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Cash Price |
$75.28
|
| Rate for Payer: Central Health Plan Commercial |
$109.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Multiplan Commercial |
$102.66
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
OP
|
$124.79
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Adventist Health Commercial |
$24.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.29
|
| Rate for Payer: Blue Shield of California Commercial |
$76.25
|
| Rate for Payer: Blue Shield of California EPN |
$49.79
|
| Rate for Payer: Cash Price |
$68.63
|
| Rate for Payer: Central Health Plan Commercial |
$99.83
|
| Rate for Payer: Cigna of CA HMO |
$79.87
|
| Rate for Payer: Cigna of CA PPO |
$92.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.92
|
| Rate for Payer: EPIC Health Plan Senior |
$49.92
|
| Rate for Payer: Galaxy Health WC |
$106.07
|
| Rate for Payer: Global Benefits Group Commercial |
$74.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.31
|
| Rate for Payer: InnovAge PACE Commercial |
$62.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.35
|
| Rate for Payer: Multiplan Commercial |
$93.59
|
| Rate for Payer: Networks By Design Commercial |
$81.11
|
| Rate for Payer: Prime Health Services Commercial |
$106.07
|
| Rate for Payer: Riverside University Health System MISP |
$49.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.40
|
| Rate for Payer: United Healthcare All Other HMO |
$62.40
|
| Rate for Payer: United Healthcare HMO Rider |
$62.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.07
|
| Rate for Payer: Vantage Medical Group Senior |
$106.07
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
IP
|
$124.79
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Adventist Health Commercial |
$24.96
|
| Rate for Payer: Cash Price |
$68.63
|
| Rate for Payer: Central Health Plan Commercial |
$99.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.92
|
| Rate for Payer: EPIC Health Plan Senior |
$49.92
|
| Rate for Payer: Galaxy Health WC |
$106.07
|
| Rate for Payer: Global Benefits Group Commercial |
$74.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.96
|
| Rate for Payer: Multiplan Commercial |
$93.59
|
| Rate for Payer: Networks By Design Commercial |
$81.11
|
| Rate for Payer: Prime Health Services Commercial |
$106.07
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
OP
|
$104.73
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Adventist Health Commercial |
$20.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.51
|
| Rate for Payer: Blue Shield of California Commercial |
$63.99
|
| Rate for Payer: Blue Shield of California EPN |
$41.79
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: Cigna of CA HMO |
$67.03
|
| Rate for Payer: Cigna of CA PPO |
$77.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Senior |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: InnovAge PACE Commercial |
$52.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.31
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Networks By Design Commercial |
$68.07
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
| Rate for Payer: Riverside University Health System MISP |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.37
|
| Rate for Payer: United Healthcare All Other HMO |
$52.37
|
| Rate for Payer: United Healthcare HMO Rider |
$52.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.02
|
| Rate for Payer: Vantage Medical Group Senior |
$89.02
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
IP
|
$104.73
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Adventist Health Commercial |
$20.95
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Senior |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Networks By Design Commercial |
$68.07
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
IP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Cash Price |
$101.91
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$114.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
OP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$138.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$89.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.82
|
| Rate for Payer: Blue Shield of California Commercial |
$113.21
|
| Rate for Payer: Blue Shield of California EPN |
$73.93
|
| Rate for Payer: Cash Price |
$101.91
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$118.59
|
| Rate for Payer: Cigna of CA PPO |
$137.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$157.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: InnovAge PACE Commercial |
$92.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$114.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$129.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$129.70
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Riverside University Health System MISP |
$74.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
OP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$186.54 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.73
|
| Rate for Payer: Blue Shield of California Commercial |
$126.64
|
| Rate for Payer: Blue Shield of California EPN |
$82.70
|
| Rate for Payer: Cash Price |
$114.00
|
| Rate for Payer: Central Health Plan Commercial |
$165.82
|
| Rate for Payer: Cigna of CA HMO |
$132.65
|
| Rate for Payer: Cigna of CA PPO |
$153.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$176.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$176.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.54
|
| Rate for Payer: InnovAge PACE Commercial |
$103.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145.09
|
| Rate for Payer: Multiplan Commercial |
$155.45
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
| Rate for Payer: Riverside University Health System MISP |
$82.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.64
|
| Rate for Payer: United Healthcare All Other HMO |
$103.64
|
| Rate for Payer: United Healthcare HMO Rider |
$103.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.18
|
| Rate for Payer: Vantage Medical Group Senior |
$176.18
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
IP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$186.54 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Cash Price |
$114.00
|
| Rate for Payer: Central Health Plan Commercial |
$165.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.45
|
| Rate for Payer: Multiplan Commercial |
$155.45
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
IP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$105.68 |
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Cash Price |
$64.58
|
| Rate for Payer: Central Health Plan Commercial |
$93.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.48
|
| Rate for Payer: Multiplan Commercial |
$88.06
|
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
OP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$105.68 |
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.96
|
| Rate for Payer: Blue Shield of California Commercial |
$71.74
|
| Rate for Payer: Blue Shield of California EPN |
$46.85
|
| Rate for Payer: Cash Price |
$64.58
|
| Rate for Payer: Central Health Plan Commercial |
$93.94
|
| Rate for Payer: Cigna of CA HMO |
$75.15
|
| Rate for Payer: Cigna of CA PPO |
$86.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.68
|
| Rate for Payer: InnovAge PACE Commercial |
$58.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.19
|
| Rate for Payer: Multiplan Commercial |
$88.06
|
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
| Rate for Payer: Riverside University Health System MISP |
$46.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.71
|
| Rate for Payer: United Healthcare All Other HMO |
$58.71
|
| Rate for Payer: United Healthcare HMO Rider |
$58.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.81
|
| Rate for Payer: Vantage Medical Group Senior |
$99.81
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
OP
|
$38.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.54
|
| Rate for Payer: Blue Shield of California Commercial |
$23.45
|
| Rate for Payer: Blue Shield of California EPN |
$15.31
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: Cigna of CA HMO |
$24.56
|
| Rate for Payer: Cigna of CA PPO |
$28.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: InnovAge PACE Commercial |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
| Rate for Payer: Riverside University Health System MISP |
$15.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.19
|
| Rate for Payer: United Healthcare HMO Rider |
$19.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.62
|
| Rate for Payer: Vantage Medical Group Senior |
$32.62
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
IP
|
$38.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
OP
|
$39.77
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.36
|
| Rate for Payer: Blue Shield of California Commercial |
$24.30
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$21.87
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.79
|
| Rate for Payer: InnovAge PACE Commercial |
$19.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Riverside University Health System MISP |
$15.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
IP
|
$39.77
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$21.87
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
OP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$16.38 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.69
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.26
|
| Rate for Payer: Cash Price |
$10.01
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: Cigna of CA HMO |
$11.65
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: InnovAge PACE Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
| Rate for Payer: Riverside University Health System MISP |
$7.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.10
|
| Rate for Payer: United Healthcare HMO Rider |
$9.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.47
|
| Rate for Payer: Vantage Medical Group Senior |
$15.47
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
IP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$16.38 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Cash Price |
$10.01
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
OP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.21
|
| Rate for Payer: Blue Shield of California Commercial |
$37.67
|
| Rate for Payer: Blue Shield of California EPN |
$24.60
|
| Rate for Payer: Cash Price |
$33.91
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: InnovAge PACE Commercial |
$30.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.16
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Riverside University Health System MISP |
$24.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
