|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
IP
|
$1,206.72
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.34 |
| Max. Negotiated Rate |
$1,086.05 |
| Rate for Payer: Adventist Health Commercial |
$241.34
|
| Rate for Payer: Blue Shield of California Commercial |
$967.79
|
| Rate for Payer: Blue Shield of California EPN |
$608.19
|
| Rate for Payer: Cash Price |
$543.02
|
| Rate for Payer: Central Health Plan Commercial |
$965.38
|
| Rate for Payer: Cigna of CA HMO |
$844.70
|
| Rate for Payer: Cigna of CA PPO |
$844.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$844.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.69
|
| Rate for Payer: EPIC Health Plan Senior |
$482.69
|
| Rate for Payer: Galaxy Health WC |
$1,025.71
|
| Rate for Payer: Global Benefits Group Commercial |
$724.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,086.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$766.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$711.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.34
|
| Rate for Payer: Multiplan Commercial |
$905.04
|
| Rate for Payer: Networks By Design Commercial |
$603.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,025.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.88
|
| Rate for Payer: United Healthcare All Other HMO |
$440.81
|
| Rate for Payer: United Healthcare HMO Rider |
$431.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.20
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
OP
|
$1,206.72
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.34 |
| Max. Negotiated Rate |
$1,086.05 |
| Rate for Payer: Adventist Health Commercial |
$241.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$663.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$905.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$661.77
|
| Rate for Payer: Blue Shield of California Commercial |
$967.79
|
| Rate for Payer: Blue Shield of California EPN |
$608.19
|
| Rate for Payer: Cash Price |
$543.02
|
| Rate for Payer: Central Health Plan Commercial |
$965.38
|
| Rate for Payer: Cigna of CA HMO |
$844.70
|
| Rate for Payer: Cigna of CA PPO |
$844.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,025.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,025.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$844.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.69
|
| Rate for Payer: EPIC Health Plan Senior |
$482.69
|
| Rate for Payer: Galaxy Health WC |
$1,025.71
|
| Rate for Payer: Global Benefits Group Commercial |
$724.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,086.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$766.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$438.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$711.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$844.70
|
| Rate for Payer: Multiplan Commercial |
$905.04
|
| Rate for Payer: Networks By Design Commercial |
$603.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,025.71
|
| Rate for Payer: Riverside University Health System MISP |
$482.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$724.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$724.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.88
|
| Rate for Payer: United Healthcare All Other HMO |
$440.81
|
| Rate for Payer: United Healthcare HMO Rider |
$431.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,025.71
|
| Rate for Payer: Vantage Medical Group Senior |
$1,025.71
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
OP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$385.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$307.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.26
|
| Rate for Payer: Blue Shield of California Commercial |
$402.46
|
| Rate for Payer: Blue Shield of California EPN |
$253.29
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$539.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$444.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$230.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$374.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$444.36
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Riverside University Health System MISP |
$253.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
IP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$444.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$403.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$374.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$339.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.01
|
| Rate for Payer: Blue Shield of California Commercial |
$596.69
|
| Rate for Payer: Blue Shield of California EPN |
$374.98
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$632.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$270.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Riverside University Health System MISP |
$297.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.40
|
| Rate for Payer: Vantage Medical Group Senior |
$632.40
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Blue Shield of California Commercial |
$596.69
|
| Rate for Payer: Blue Shield of California EPN |
$374.98
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
OP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$92.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$126.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$81.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.30
|
| Rate for Payer: Blue Shield of California Commercial |
$107.13
|
| Rate for Payer: Blue Shield of California EPN |
$67.42
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Central Health Plan Commercial |
$135.18
|
| Rate for Payer: Cigna of CA HMO |
$108.15
|
| Rate for Payer: Cigna of CA PPO |
$125.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$143.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$143.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$118.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$118.29
|
| Rate for Payer: Multiplan Commercial |
$126.73
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
| Rate for Payer: Riverside University Health System MISP |
$67.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.49
|
| Rate for Payer: United Healthcare All Other HMO |
$84.49
|
| Rate for Payer: United Healthcare HMO Rider |
$84.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.63
|
| Rate for Payer: Vantage Medical Group Senior |
$143.63
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
IP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Central Health Plan Commercial |
$135.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$118.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Multiplan Commercial |
$126.73
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
OP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$774.18 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$522.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$645.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$416.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$500.38
|
| Rate for Payer: Blue Shield of California Commercial |
$545.37
|
| Rate for Payer: Blue Shield of California EPN |
$343.22
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Central Health Plan Commercial |
$688.16
|
| Rate for Payer: Cigna of CA HMO |
$550.53
|
| Rate for Payer: Cigna of CA PPO |
$636.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$731.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$602.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$546.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$312.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$507.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$602.14
|
| Rate for Payer: Multiplan Commercial |
$645.15
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
| Rate for Payer: Riverside University Health System MISP |
$344.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$430.10
|
| Rate for Payer: United Healthcare All Other HMO |
$430.10
|
| Rate for Payer: United Healthcare HMO Rider |
$430.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$430.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Vantage Medical Group Senior |
$731.17
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
IP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$774.18 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Central Health Plan Commercial |
$688.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$602.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$546.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$507.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.04
|
| Rate for Payer: Multiplan Commercial |
$645.15
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
OP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$480.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$383.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$460.24
|
| Rate for Payer: Blue Shield of California Commercial |
$501.62
|
| Rate for Payer: Blue Shield of California EPN |
$315.69
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$506.37
|
| Rate for Payer: Cigna of CA PPO |
$585.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$287.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Riverside University Health System MISP |
$316.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$395.60
|
| Rate for Payer: United Healthcare All Other HMO |
$395.60
|
| Rate for Payer: United Healthcare HMO Rider |
$395.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
IP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
|
|
HC CATH TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
OP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.39
|
| Rate for Payer: Blue Shield of California Commercial |
$110.26
|
| Rate for Payer: Blue Shield of California EPN |
$69.29
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Central Health Plan Commercial |
$109.98
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$96.24
|
| Rate for Payer: Multiplan Commercial |
$103.11
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: Riverside University Health System MISP |
$54.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.86
|
| Rate for Payer: Vantage Medical Group Senior |
$116.86
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
IP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Blue Shield of California Commercial |
$110.26
|
| Rate for Payer: Blue Shield of California EPN |
$69.29
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Central Health Plan Commercial |
$109.98
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$103.11
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
IP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$117.99 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Blue Shield of California Commercial |
$105.14
|
| Rate for Payer: Blue Shield of California EPN |
$66.07
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Central Health Plan Commercial |
$104.88
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.22
|
| Rate for Payer: Multiplan Commercial |
$98.33
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
OP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$117.99 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.90
|
| Rate for Payer: Blue Shield of California Commercial |
$105.14
|
| Rate for Payer: Blue Shield of California EPN |
$66.07
|
| Rate for Payer: Cash Price |
$59.00
|
| Rate for Payer: Central Health Plan Commercial |
$104.88
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$91.77
|
| Rate for Payer: Multiplan Commercial |
$98.33
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: Riverside University Health System MISP |
$52.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.44
|
| Rate for Payer: Vantage Medical Group Senior |
$111.44
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
OP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$120.65 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.52
|
| Rate for Payer: Blue Shield of California Commercial |
$107.52
|
| Rate for Payer: Blue Shield of California EPN |
$67.57
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Central Health Plan Commercial |
$107.25
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$100.55
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: Riverside University Health System MISP |
$53.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.95
|
| Rate for Payer: Vantage Medical Group Senior |
$113.95
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
IP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$120.65 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Blue Shield of California Commercial |
$107.52
|
| Rate for Payer: Blue Shield of California EPN |
$67.57
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Central Health Plan Commercial |
$107.25
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.81
|
| Rate for Payer: Multiplan Commercial |
$100.55
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$86.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.43
|
| Rate for Payer: Blue Shield of California Commercial |
$92.77
|
| Rate for Payer: Blue Shield of California EPN |
$58.30
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Central Health Plan Commercial |
$92.54
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$98.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$98.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$80.97
|
| Rate for Payer: Multiplan Commercial |
$86.75
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: Riverside University Health System MISP |
$46.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$98.32
|
| Rate for Payer: Vantage Medical Group Senior |
$98.32
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Blue Shield of California Commercial |
$92.77
|
| Rate for Payer: Blue Shield of California EPN |
$58.30
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Central Health Plan Commercial |
$92.54
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.13
|
| Rate for Payer: Multiplan Commercial |
$86.75
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
IP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$87.62 |
| Rate for Payer: Adventist Health Commercial |
$19.47
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Central Health Plan Commercial |
$77.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.47
|
| Rate for Payer: Multiplan Commercial |
$73.02
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
|
