|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
OP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$396.77 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$201.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.10
|
| Rate for Payer: Blue Shield of California Commercial |
$340.78
|
| Rate for Payer: Blue Shield of California EPN |
$222.19
|
| Rate for Payer: Cash Price |
$242.47
|
| Rate for Payer: Central Health Plan Commercial |
$352.69
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.77
|
| Rate for Payer: InnovAge PACE Commercial |
$220.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.60
|
| Rate for Payer: Multiplan Commercial |
$330.64
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: Riverside University Health System MISP |
$176.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.73
|
| Rate for Payer: Vantage Medical Group Senior |
$374.73
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
OP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$19.33 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.62
|
| Rate for Payer: Blue Shield of California Commercial |
$13.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.57
|
| Rate for Payer: Cash Price |
$11.81
|
| Rate for Payer: Central Health Plan Commercial |
$17.18
|
| Rate for Payer: Cigna of CA HMO |
$13.75
|
| Rate for Payer: Cigna of CA PPO |
$15.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.33
|
| Rate for Payer: InnovAge PACE Commercial |
$10.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.04
|
| Rate for Payer: Multiplan Commercial |
$16.11
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
| Rate for Payer: Riverside University Health System MISP |
$8.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO |
$10.74
|
| Rate for Payer: United Healthcare HMO Rider |
$10.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.26
|
| Rate for Payer: Vantage Medical Group Senior |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
IP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$19.33 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Cash Price |
$11.81
|
| Rate for Payer: Central Health Plan Commercial |
$17.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.30
|
| Rate for Payer: Multiplan Commercial |
$16.11
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
OP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$31.07 |
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.27
|
| Rate for Payer: Blue Shield of California Commercial |
$21.09
|
| Rate for Payer: Blue Shield of California EPN |
$13.77
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Central Health Plan Commercial |
$27.62
|
| Rate for Payer: Cigna of CA HMO |
$22.09
|
| Rate for Payer: Cigna of CA PPO |
$25.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.07
|
| Rate for Payer: InnovAge PACE Commercial |
$17.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.16
|
| Rate for Payer: Multiplan Commercial |
$25.89
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
| Rate for Payer: Riverside University Health System MISP |
$13.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.26
|
| Rate for Payer: United Healthcare All Other HMO |
$17.26
|
| Rate for Payer: United Healthcare HMO Rider |
$17.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.34
|
| Rate for Payer: Vantage Medical Group Senior |
$29.34
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
IP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$31.07 |
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Central Health Plan Commercial |
$27.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.90
|
| Rate for Payer: Multiplan Commercial |
$25.89
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
OP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,190.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,984.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,705.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,746.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,118.68
|
| Rate for Payer: Blue Shield of California Commercial |
$2,204.18
|
| Rate for Payer: Blue Shield of California EPN |
$1,439.39
|
| Rate for Payer: Cash Price |
$1,984.13
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: Cigna of CA HMO |
$2,308.80
|
| Rate for Payer: Cigna of CA PPO |
$2,669.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,066.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,066.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: InnovAge PACE Commercial |
$1,803.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,233.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,525.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,525.25
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
| Rate for Payer: Riverside University Health System MISP |
$1,443.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,164.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,164.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,803.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,803.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,803.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,803.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Senior |
$3,066.38
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
IP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Cash Price |
$1,984.13
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,233.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
OP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,851.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,841.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,233.21
|
| Rate for Payer: Blue Shield of California Commercial |
$2,323.33
|
| Rate for Payer: Blue Shield of California EPN |
$1,517.20
|
| Rate for Payer: Cash Price |
$2,091.38
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: Cigna of CA HMO |
$2,433.60
|
| Rate for Payer: Cigna of CA PPO |
$2,813.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: InnovAge PACE Commercial |
$1,901.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,661.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,661.75
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
| Rate for Payer: Riverside University Health System MISP |
$1,521.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.12
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
IP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Cash Price |
$2,091.38
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
|
|
HC CATH INDIGO THROM
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
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 INDIGO THROM
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
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 INFUSION SL 7FR 16CM SL
|
Facility
|
OP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.21
|
| Rate for Payer: Blue Shield of California Commercial |
$65.91
|
| Rate for Payer: Blue Shield of California EPN |
$42.98
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: InnovAge PACE Commercial |
$42.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.69
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Riverside University Health System MISP |
$34.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
IP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Blue Shield of California Commercial |
$65.91
|
| Rate for Payer: Blue Shield of California EPN |
$42.98
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
IP
|
$101.46
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$91.31 |
| Rate for Payer: Adventist Health Commercial |
$20.29
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$81.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.58
|
| Rate for Payer: EPIC Health Plan Senior |
$40.58
|
| Rate for Payer: Galaxy Health WC |
$86.24
|
| Rate for Payer: Global Benefits Group Commercial |
$60.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.29
|
| Rate for Payer: Multiplan Commercial |
$76.09
|
| Rate for Payer: Networks By Design Commercial |
$65.95
|
| Rate for Payer: Prime Health Services Commercial |
$86.24
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
OP
|
$101.46
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$91.31 |
| Rate for Payer: Adventist Health Commercial |
$20.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.59
|
| Rate for Payer: Blue Shield of California Commercial |
$61.99
|
| Rate for Payer: Blue Shield of California EPN |
$40.48
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Central Health Plan Commercial |
$81.17
|
| Rate for Payer: Cigna of CA HMO |
$64.93
|
| Rate for Payer: Cigna of CA PPO |
$75.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.58
|
| Rate for Payer: EPIC Health Plan Senior |
$40.58
|
| Rate for Payer: Galaxy Health WC |
$86.24
|
| Rate for Payer: Global Benefits Group Commercial |
$60.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.31
|
| Rate for Payer: InnovAge PACE Commercial |
$50.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.02
|
| Rate for Payer: Multiplan Commercial |
$76.09
|
| Rate for Payer: Networks By Design Commercial |
$65.95
|
| Rate for Payer: Prime Health Services Commercial |
$86.24
|
| Rate for Payer: Riverside University Health System MISP |
$40.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.73
|
| Rate for Payer: United Healthcare All Other HMO |
$50.73
|
| Rate for Payer: United Healthcare HMO Rider |
$50.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.24
|
| Rate for Payer: Vantage Medical Group Senior |
$86.24
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.96
|
| Rate for Payer: Blue Shield of California EPN |
$1.28
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: Cigna of CA HMO |
$2.05
|
| Rate for Payer: Cigna of CA PPO |
$2.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: InnovAge PACE Commercial |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.24
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
| Rate for Payer: Riverside University Health System MISP |
$1.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.72
|
| Rate for Payer: Vantage Medical Group Senior |
$2.72
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 7.5FR 40CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 8FR 50CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 9FR 50ML
|
Facility
|
IP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Cash Price |
$1,824.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Multiplan Commercial |
$2,488.09
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
OP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,014.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,488.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,606.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,948.34
|
| Rate for Payer: Blue Shield of California Commercial |
$2,026.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,323.67
|
| Rate for Payer: Cash Price |
$1,824.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: Cigna of CA HMO |
$2,123.17
|
| Rate for Payer: Cigna of CA PPO |
$2,454.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,819.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,819.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: InnovAge PACE Commercial |
$1,658.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,322.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,322.22
|
| Rate for Payer: Multiplan Commercial |
$2,488.09
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,326.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.73
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,819.84
|
|
