|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
IP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698973
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.23
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Cigna of CA HMO |
$3.57
|
| Rate for Payer: Cigna of CA PPO |
$4.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.79
|
| Rate for Payer: United Healthcare All Other HMO |
$2.79
|
| Rate for Payer: United Healthcare HMO Rider |
$2.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698973
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.23
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Cigna of CA HMO |
$3.57
|
| Rate for Payer: Cigna of CA PPO |
$4.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.79
|
| Rate for Payer: United Healthcare All Other HMO |
$2.79
|
| Rate for Payer: United Healthcare HMO Rider |
$2.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
IP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
OP
|
$4.92
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.86
|
| Rate for Payer: Blue Shield of California Commercial |
$3.12
|
| Rate for Payer: Blue Shield of California EPN |
$1.96
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Central Health Plan Commercial |
$3.94
|
| Rate for Payer: Cigna of CA HMO |
$3.15
|
| Rate for Payer: Cigna of CA PPO |
$3.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$3.69
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
| Rate for Payer: Riverside University Health System MISP |
$1.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.46
|
| Rate for Payer: United Healthcare All Other HMO |
$2.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$4.18
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698971
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
IP
|
$4.92
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Central Health Plan Commercial |
$3.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.98
|
| Rate for Payer: Multiplan Commercial |
$3.69
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698971
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.23
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Cigna of CA HMO |
$3.57
|
| Rate for Payer: Cigna of CA PPO |
$4.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.79
|
| Rate for Payer: United Healthcare All Other HMO |
$2.79
|
| Rate for Payer: United Healthcare HMO Rider |
$2.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
IP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698969
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.23
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Cigna of CA HMO |
$3.57
|
| Rate for Payer: Cigna of CA PPO |
$4.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.79
|
| Rate for Payer: United Healthcare All Other HMO |
$2.79
|
| Rate for Payer: United Healthcare HMO Rider |
$2.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698969
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
IP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
IP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$5.02 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$1.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.23
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Central Health Plan Commercial |
$4.46
|
| Rate for Payer: Cigna of CA HMO |
$3.57
|
| Rate for Payer: Cigna of CA PPO |
$4.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.23
|
| Rate for Payer: EPIC Health Plan Senior |
$2.23
|
| Rate for Payer: Galaxy Health WC |
$4.74
|
| Rate for Payer: Global Benefits Group Commercial |
$3.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$4.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.79
|
| Rate for Payer: United Healthcare All Other HMO |
$2.79
|
| Rate for Payer: United Healthcare HMO Rider |
$2.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.74
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698974
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.93
|
| Rate for Payer: United Healthcare All Other HMO |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
