|
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
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
IP
|
$65.44
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Cash Price |
$35.99
|
| Rate for Payer: Central Health Plan Commercial |
$52.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$49.08
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
OP
|
$65.44
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.43
|
| Rate for Payer: Blue Shield of California Commercial |
$39.98
|
| Rate for Payer: Blue Shield of California EPN |
$26.11
|
| Rate for Payer: Cash Price |
$35.99
|
| Rate for Payer: Central Health Plan Commercial |
$52.35
|
| Rate for Payer: Cigna of CA HMO |
$41.88
|
| Rate for Payer: Cigna of CA PPO |
$48.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.90
|
| Rate for Payer: InnovAge PACE Commercial |
$32.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.81
|
| Rate for Payer: Multiplan Commercial |
$49.08
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
| Rate for Payer: Riverside University Health System MISP |
$26.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.72
|
| Rate for Payer: United Healthcare All Other HMO |
$32.72
|
| Rate for Payer: United Healthcare HMO Rider |
$32.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.62
|
| Rate for Payer: Vantage Medical Group Senior |
$55.62
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
OP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.04
|
| Rate for Payer: Blue Shield of California Commercial |
$34.37
|
| Rate for Payer: Blue Shield of California EPN |
$22.44
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Central Health Plan Commercial |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$36.00
|
| Rate for Payer: Cigna of CA PPO |
$41.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.62
|
| Rate for Payer: InnovAge PACE Commercial |
$28.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.38
|
| Rate for Payer: Multiplan Commercial |
$42.19
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
| Rate for Payer: Riverside University Health System MISP |
$22.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.12
|
| Rate for Payer: United Healthcare All Other HMO |
$28.12
|
| Rate for Payer: United Healthcare HMO Rider |
$28.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.81
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
IP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Central Health Plan Commercial |
$45.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$42.19
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
OP
|
$64.94
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$58.45 |
| Rate for Payer: Adventist Health Commercial |
$12.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.14
|
| Rate for Payer: Blue Shield of California Commercial |
$39.68
|
| Rate for Payer: Blue Shield of California EPN |
$25.91
|
| Rate for Payer: Cash Price |
$35.72
|
| Rate for Payer: Central Health Plan Commercial |
$51.95
|
| Rate for Payer: Cigna of CA HMO |
$41.56
|
| Rate for Payer: Cigna of CA PPO |
$48.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.98
|
| Rate for Payer: EPIC Health Plan Senior |
$25.98
|
| Rate for Payer: Galaxy Health WC |
$55.20
|
| Rate for Payer: Global Benefits Group Commercial |
$38.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.45
|
| Rate for Payer: InnovAge PACE Commercial |
$32.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.46
|
| Rate for Payer: Multiplan Commercial |
$48.70
|
| Rate for Payer: Networks By Design Commercial |
$42.21
|
| Rate for Payer: Prime Health Services Commercial |
$55.20
|
| Rate for Payer: Riverside University Health System MISP |
$25.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.47
|
| Rate for Payer: United Healthcare All Other HMO |
$32.47
|
| Rate for Payer: United Healthcare HMO Rider |
$32.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.20
|
| Rate for Payer: Vantage Medical Group Senior |
$55.20
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
IP
|
$64.94
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$58.45 |
| Rate for Payer: Adventist Health Commercial |
$12.99
|
| Rate for Payer: Cash Price |
$35.72
|
| Rate for Payer: Central Health Plan Commercial |
$51.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.98
|
| Rate for Payer: EPIC Health Plan Senior |
$25.98
|
| Rate for Payer: Galaxy Health WC |
$55.20
|
| Rate for Payer: Global Benefits Group Commercial |
$38.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.99
|
| Rate for Payer: Multiplan Commercial |
$48.70
|
| Rate for Payer: Networks By Design Commercial |
$42.21
|
| Rate for Payer: Prime Health Services Commercial |
$55.20
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.16
|
| Rate for Payer: Blue Shield of California Commercial |
$50.10
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: InnovAge PACE Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$29.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.36
|
| Rate for Payer: Multiplan Commercial |
$27.61
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.62
|
| Rate for Payer: Blue Shield of California Commercial |
$22.50
|
| Rate for Payer: Blue Shield of California EPN |
$14.69
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$29.46
|
| Rate for Payer: Cigna of CA HMO |
$23.56
|
| Rate for Payer: Cigna of CA PPO |
$27.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.14
|
| Rate for Payer: InnovAge PACE Commercial |
$18.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.77
|
| Rate for Payer: Multiplan Commercial |
$27.61
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
| Rate for Payer: Riverside University Health System MISP |
$14.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.41
|
| Rate for Payer: United Healthcare All Other HMO |
$18.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.30
|
| Rate for Payer: Vantage Medical Group Senior |
$31.30
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.78
|
| Rate for Payer: Blue Shield of California Commercial |
$19.54
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: InnovAge PACE Commercial |
$15.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
OP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$35.72 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.31
|
| Rate for Payer: Blue Shield of California Commercial |
$24.25
|
| Rate for Payer: Blue Shield of California EPN |
$15.84
|
| Rate for Payer: Cash Price |
$21.83
|
| Rate for Payer: Central Health Plan Commercial |
$31.75
|
| Rate for Payer: Cigna of CA HMO |
$25.40
|
| Rate for Payer: Cigna of CA PPO |
$29.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.72
|
| Rate for Payer: InnovAge PACE Commercial |
$19.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.78
|
| Rate for Payer: Multiplan Commercial |
$29.77
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
| Rate for Payer: Riverside University Health System MISP |
$15.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.84
|
| Rate for Payer: United Healthcare All Other HMO |
$19.84
|
| Rate for Payer: United Healthcare HMO Rider |
$19.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.74
|
| Rate for Payer: Vantage Medical Group Senior |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
IP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$35.72 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Cash Price |
$21.83
|
| Rate for Payer: Central Health Plan Commercial |
$31.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.94
|
| Rate for Payer: Multiplan Commercial |
$29.77
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.78
|
| Rate for Payer: Blue Shield of California Commercial |
$19.54
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: InnovAge PACE Commercial |
$15.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
IP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
OP
|
$31.98
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.78
|
| Rate for Payer: Blue Shield of California Commercial |
$19.54
|
| Rate for Payer: Blue Shield of California EPN |
$12.76
|
| Rate for Payer: Cash Price |
$17.59
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Senior |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: InnovAge PACE Commercial |
$15.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.39
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Riverside University Health System MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
OP
|
$25.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$22.88 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.93
|
| Rate for Payer: Blue Shield of California Commercial |
$15.53
|
| Rate for Payer: Blue Shield of California EPN |
$10.14
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Central Health Plan Commercial |
$20.34
|
| Rate for Payer: Cigna of CA HMO |
$16.27
|
| Rate for Payer: Cigna of CA PPO |
$18.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.17
|
| Rate for Payer: EPIC Health Plan Senior |
$10.17
|
| Rate for Payer: Galaxy Health WC |
$21.61
|
| Rate for Payer: Global Benefits Group Commercial |
$15.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.88
|
| Rate for Payer: InnovAge PACE Commercial |
$12.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.79
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
| Rate for Payer: Networks By Design Commercial |
$16.52
|
| Rate for Payer: Prime Health Services Commercial |
$21.61
|
| Rate for Payer: Riverside University Health System MISP |
$10.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.71
|
| Rate for Payer: United Healthcare All Other HMO |
$12.71
|
| Rate for Payer: United Healthcare HMO Rider |
$12.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.61
|
| Rate for Payer: Vantage Medical Group Senior |
$21.61
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
IP
|
$25.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$22.88 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Central Health Plan Commercial |
$20.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.17
|
| Rate for Payer: EPIC Health Plan Senior |
$10.17
|
| Rate for Payer: Galaxy Health WC |
$21.61
|
| Rate for Payer: Global Benefits Group Commercial |
$15.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
| Rate for Payer: Networks By Design Commercial |
$16.52
|
| Rate for Payer: Prime Health Services Commercial |
$21.61
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.02
|
| Rate for Payer: Blue Shield of California Commercial |
$15.63
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Cash Price |
$14.07
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Cigna of CA HMO |
$16.37
|
| Rate for Payer: Cigna of CA PPO |
$18.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: InnovAge PACE Commercial |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.91
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare HMO Rider |
$12.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.74
|
| Rate for Payer: Vantage Medical Group Senior |
$21.74
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Cash Price |
$14.07
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
IP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Cash Price |
$14.07
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
OP
|
$25.58
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$23.02 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.02
|
| Rate for Payer: Blue Shield of California Commercial |
$15.63
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Cash Price |
$14.07
|
| Rate for Payer: Central Health Plan Commercial |
$20.46
|
| Rate for Payer: Cigna of CA HMO |
$16.37
|
| Rate for Payer: Cigna of CA PPO |
$18.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$21.74
|
| Rate for Payer: Global Benefits Group Commercial |
$15.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.02
|
| Rate for Payer: InnovAge PACE Commercial |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.91
|
| Rate for Payer: Multiplan Commercial |
$19.18
|
| Rate for Payer: Networks By Design Commercial |
$16.63
|
| Rate for Payer: Prime Health Services Commercial |
$21.74
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare HMO Rider |
$12.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.74
|
| Rate for Payer: Vantage Medical Group Senior |
$21.74
|
|
