|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
IP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$27.38 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Central Health Plan Commercial |
$24.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
OP
|
$131.48
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.30 |
| Max. Negotiated Rate |
$118.33 |
| Rate for Payer: Adventist Health Commercial |
$26.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$79.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.22
|
| Rate for Payer: Blue Shield of California Commercial |
$80.33
|
| Rate for Payer: Blue Shield of California EPN |
$52.46
|
| Rate for Payer: Cash Price |
$72.31
|
| Rate for Payer: Central Health Plan Commercial |
$105.18
|
| Rate for Payer: Cigna of CA HMO |
$84.15
|
| Rate for Payer: Cigna of CA PPO |
$97.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.59
|
| Rate for Payer: EPIC Health Plan Senior |
$52.59
|
| Rate for Payer: Galaxy Health WC |
$111.76
|
| Rate for Payer: Global Benefits Group Commercial |
$78.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.33
|
| Rate for Payer: InnovAge PACE Commercial |
$65.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$92.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92.04
|
| Rate for Payer: Multiplan Commercial |
$98.61
|
| Rate for Payer: Networks By Design Commercial |
$85.46
|
| Rate for Payer: Prime Health Services Commercial |
$111.76
|
| Rate for Payer: Riverside University Health System MISP |
$52.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$65.74
|
| Rate for Payer: United Healthcare All Other HMO |
$65.74
|
| Rate for Payer: United Healthcare HMO Rider |
$65.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.76
|
| Rate for Payer: Vantage Medical Group Senior |
$111.76
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
IP
|
$131.48
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.30 |
| Max. Negotiated Rate |
$118.33 |
| Rate for Payer: Adventist Health Commercial |
$26.30
|
| Rate for Payer: Cash Price |
$72.31
|
| Rate for Payer: Central Health Plan Commercial |
$105.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.59
|
| Rate for Payer: EPIC Health Plan Senior |
$52.59
|
| Rate for Payer: Galaxy Health WC |
$111.76
|
| Rate for Payer: Global Benefits Group Commercial |
$78.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.30
|
| Rate for Payer: Multiplan Commercial |
$98.61
|
| Rate for Payer: Networks By Design Commercial |
$85.46
|
| Rate for Payer: Prime Health Services Commercial |
$111.76
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.55
|
| Rate for Payer: Blue Shield of California Commercial |
$20.34
|
| Rate for Payer: Blue Shield of California EPN |
$13.28
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: Cigna of CA HMO |
$21.31
|
| Rate for Payer: Cigna of CA PPO |
$24.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: InnovAge PACE Commercial |
$16.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.30
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
| Rate for Payer: Riverside University Health System MISP |
$13.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.64
|
| Rate for Payer: United Healthcare All Other HMO |
$16.64
|
| Rate for Payer: United Healthcare HMO Rider |
$16.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.30
|
| Rate for Payer: Vantage Medical Group Senior |
$28.30
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Blue Shield of California Commercial |
$462.25
|
| Rate for Payer: Blue Shield of California EPN |
$301.39
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$418.60
|
| Rate for Payer: Cigna of CA PPO |
$418.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.43
|
| Rate for Payer: United Healthcare All Other HMO |
$218.45
|
| Rate for Payer: United Healthcare HMO Rider |
$213.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.84
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$273.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$331.11
|
| Rate for Payer: Blue Shield of California Commercial |
$462.25
|
| Rate for Payer: Blue Shield of California EPN |
$301.39
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$418.60
|
| Rate for Payer: Cigna of CA PPO |
$418.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$508.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$508.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$508.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: InnovAge PACE Commercial |
$299.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$418.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Riverside University Health System MISP |
$239.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.43
|
| Rate for Payer: United Healthcare All Other HMO |
$218.45
|
| Rate for Payer: United Healthcare HMO Rider |
$213.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$508.30
|
| Rate for Payer: Vantage Medical Group Senior |
$508.30
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
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 |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| 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 GUIDE CELLO
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
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 |
$2,159.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| 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: 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: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA 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 GUIDT RAPIDO ADVANCE
|
Facility
|
IP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$644.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$796.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$514.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$623.71
|
| Rate for Payer: Blue Shield of California Commercial |
$648.88
|
| Rate for Payer: Blue Shield of California EPN |
$423.74
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: Cigna of CA HMO |
$679.68
|
| Rate for Payer: Cigna of CA PPO |
$785.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$902.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: InnovAge PACE Commercial |
$531.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$743.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$743.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
| Rate for Payer: Riverside University Health System MISP |
$424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.00
|
| Rate for Payer: United Healthcare All Other HMO |
$531.00
|
| Rate for Payer: United Healthcare HMO Rider |
$531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.70
|
| Rate for Payer: Vantage Medical Group Senior |
$902.70
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$273.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$264.29
|
| Rate for Payer: Blue Shield of California Commercial |
$274.95
|
| Rate for Payer: Blue Shield of California EPN |
$179.55
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: InnovAge PACE Commercial |
$225.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Riverside University Health System MISP |
$180.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$273.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$264.29
|
| Rate for Payer: Blue Shield of California Commercial |
$274.95
|
| Rate for Payer: Blue Shield of California EPN |
$179.55
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: InnovAge PACE Commercial |
$225.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Riverside University Health System MISP |
$180.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC CATH GUIDT SWIFT NINJA
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,656.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,225.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,699.29
|
| Rate for Payer: Blue Shield of California Commercial |
$3,768.38
|
| Rate for Payer: Blue Shield of California EPN |
$2,457.00
|
| Rate for Payer: Cash Price |
$2,681.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,437.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,017.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,412.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,412.50
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH GUIDT SWIFT NINJA
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,768.38
|
| Rate for Payer: Blue Shield of California EPN |
$2,457.00
|
| Rate for Payer: Cash Price |
$2,681.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,017.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
|
OP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$830.15 |
| Rate for Payer: Adventist Health Commercial |
$184.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$691.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$510.73
|
| Rate for Payer: Blue Shield of California Commercial |
$713.01
|
| Rate for Payer: Blue Shield of California EPN |
$464.88
|
| Rate for Payer: Cash Price |
$507.31
|
| Rate for Payer: Central Health Plan Commercial |
$737.91
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$784.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$784.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Senior |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$830.15
|
| Rate for Payer: InnovAge PACE Commercial |
$461.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$570.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$645.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$645.67
|
| Rate for Payer: Multiplan Commercial |
$691.79
|
| Rate for Payer: Networks By Design Commercial |
$461.19
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
| Rate for Payer: Riverside University Health System MISP |
$368.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$553.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$553.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.17
|
| Rate for Payer: United Healthcare All Other HMO |
$336.95
|
| Rate for Payer: United Healthcare HMO Rider |
$329.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$784.03
|
| Rate for Payer: Vantage Medical Group Senior |
$784.03
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
|
IP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$830.15 |
| Rate for Payer: Adventist Health Commercial |
$184.48
|
| Rate for Payer: Blue Shield of California Commercial |
$713.01
|
| Rate for Payer: Blue Shield of California EPN |
$464.88
|
| Rate for Payer: Cash Price |
$507.31
|
| Rate for Payer: Central Health Plan Commercial |
$737.91
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Senior |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$830.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$570.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.48
|
| Rate for Payer: Multiplan Commercial |
$691.79
|
| Rate for Payer: Networks By Design Commercial |
$461.19
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.17
|
| Rate for Payer: United Healthcare All Other HMO |
$336.95
|
| Rate for Payer: United Healthcare HMO Rider |
$329.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.08
|
|
|
HC CATH HEMO-CATH 8FR 12CM PEDS
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603577
|
|
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 |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| 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: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$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 HEMO-CATH 8FR 12CM PEDS
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603577
|
|
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 |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| 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: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$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 HEMODIALYSIS DBL LUMEN
|
Facility
|
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
|
|
HC CATH HEMODIALYSIS DBL LUMEN
|
Facility
|
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$305.16
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: InnovAge PACE Commercial |
$275.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.78
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health System MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMODIALYSIS LONG TERM
|
Facility
|
OP
|
$2,148.20
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$429.64 |
| Max. Negotiated Rate |
$1,933.38 |
| Rate for Payer: Adventist Health Commercial |
$429.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,825.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,181.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,611.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$980.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,189.46
|
| Rate for Payer: Blue Shield of California Commercial |
$1,660.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,082.69
|
| Rate for Payer: Cash Price |
$1,181.51
|
| Rate for Payer: Central Health Plan Commercial |
$1,718.56
|
| Rate for Payer: Cigna of CA HMO |
$1,503.74
|
| Rate for Payer: Cigna of CA PPO |
$1,503.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,825.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,825.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,825.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.28
|
| Rate for Payer: EPIC Health Plan Senior |
$859.28
|
| Rate for Payer: Galaxy Health WC |
$1,825.97
|
| Rate for Payer: Global Benefits Group Commercial |
$1,288.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,933.38
|
| Rate for Payer: InnovAge PACE Commercial |
$1,074.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,432.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$818.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,329.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,503.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,503.74
|
| Rate for Payer: Multiplan Commercial |
$1,611.15
|
| Rate for Payer: Networks By Design Commercial |
$1,074.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,825.97
|
| Rate for Payer: Riverside University Health System MISP |
$859.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,288.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,288.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$806.22
|
| Rate for Payer: United Healthcare All Other HMO |
$784.74
|
| Rate for Payer: United Healthcare HMO Rider |
$767.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$703.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,825.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,825.97
|
| Rate for Payer: Vantage Medical Group Senior |
$1,825.97
|
|
|
HC CATH HEMODIALYSIS LONG TERM
|
Facility
|
IP
|
$2,148.20
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$429.64 |
| Max. Negotiated Rate |
$1,933.38 |
| Rate for Payer: Adventist Health Commercial |
$429.64
|
| Rate for Payer: Blue Shield of California Commercial |
$1,660.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,082.69
|
| Rate for Payer: Cash Price |
$1,181.51
|
| Rate for Payer: Central Health Plan Commercial |
$1,718.56
|
| Rate for Payer: Cigna of CA HMO |
$1,503.74
|
| Rate for Payer: Cigna of CA PPO |
$1,503.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.28
|
| Rate for Payer: EPIC Health Plan Senior |
$859.28
|
| Rate for Payer: Galaxy Health WC |
$1,825.97
|
| Rate for Payer: Global Benefits Group Commercial |
$1,288.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,933.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,432.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$818.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,329.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.64
|
| Rate for Payer: Multiplan Commercial |
$1,611.15
|
| Rate for Payer: Networks By Design Commercial |
$1,074.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,825.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$806.22
|
| Rate for Payer: United Healthcare All Other HMO |
$784.74
|
| Rate for Payer: United Healthcare HMO Rider |
$767.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$703.54
|
|
