|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$533.70 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$504.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$326.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$444.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$344.95
|
| Rate for Payer: Blue Shield of California Commercial |
$375.96
|
| Rate for Payer: Blue Shield of California EPN |
$236.61
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Central Health Plan Commercial |
$474.40
|
| Rate for Payer: Cigna of CA HMO |
$379.52
|
| Rate for Payer: Cigna of CA PPO |
$438.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$504.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$415.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: EPIC Health Plan Senior |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$533.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$376.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$349.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$415.10
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
| Rate for Payer: Riverside University Health System MISP |
$237.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$355.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$355.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.50
|
| Rate for Payer: United Healthcare All Other HMO |
$296.50
|
| Rate for Payer: United Healthcare HMO Rider |
$296.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$504.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.05
|
| Rate for Payer: Vantage Medical Group Senior |
$504.05
|
|
|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$533.70 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Central Health Plan Commercial |
$474.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$415.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: EPIC Health Plan Senior |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$533.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$376.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$349.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.60
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$389.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$468.27
|
| Rate for Payer: Blue Shield of California Commercial |
$510.37
|
| Rate for Payer: Blue Shield of California EPN |
$321.19
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$292.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$402.50
|
| Rate for Payer: United Healthcare All Other HMO |
$402.50
|
| Rate for Payer: United Healthcare HMO Rider |
$402.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$402.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
OP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$822.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,121.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$723.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$869.64
|
| Rate for Payer: Blue Shield of California Commercial |
$947.83
|
| Rate for Payer: Blue Shield of California EPN |
$596.50
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Cigna of CA HMO |
$956.80
|
| Rate for Payer: Cigna of CA PPO |
$1,106.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,270.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,270.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,046.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$949.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$542.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$882.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,046.50
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
| Rate for Payer: Riverside University Health System MISP |
$598.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$747.50
|
| Rate for Payer: United Healthcare All Other HMO |
$747.50
|
| Rate for Payer: United Healthcare HMO Rider |
$747.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$747.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,270.75
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
IP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,046.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$949.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$882.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,337.91
|
| Rate for Payer: Blue Shield of California Commercial |
$1,458.20
|
| Rate for Payer: Blue Shield of California EPN |
$917.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
OP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$451.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$615.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$477.74
|
| Rate for Payer: Blue Shield of California Commercial |
$520.69
|
| Rate for Payer: Blue Shield of California EPN |
$327.69
|
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: Cigna of CA HMO |
$525.62
|
| Rate for Payer: Cigna of CA PPO |
$607.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$574.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$521.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$298.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$484.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$574.90
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
| Rate for Payer: Riverside University Health System MISP |
$328.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$492.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$492.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$410.64
|
| Rate for Payer: United Healthcare All Other HMO |
$410.64
|
| Rate for Payer: United Healthcare HMO Rider |
$410.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$410.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.09
|
| Rate for Payer: Vantage Medical Group Senior |
$698.09
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
IP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$574.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$521.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$484.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,337.91
|
| Rate for Payer: Blue Shield of California Commercial |
$1,458.20
|
| Rate for Payer: Blue Shield of California EPN |
$917.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VIRDEN
|
Facility
|
IP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$199.58 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Cash Price |
$99.79
|
| Rate for Payer: Central Health Plan Commercial |
$177.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$155.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.35
|
| Rate for Payer: Multiplan Commercial |
$166.32
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
|
|
HC CATH VIRDEN
|
Facility
|
OP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$199.58 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$166.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.00
|
| Rate for Payer: Blue Shield of California Commercial |
$140.60
|
| Rate for Payer: Blue Shield of California EPN |
$88.48
|
| Rate for Payer: Cash Price |
$99.79
|
| Rate for Payer: Central Health Plan Commercial |
$177.41
|
| Rate for Payer: Cigna of CA HMO |
$141.93
|
| Rate for Payer: Cigna of CA PPO |
$164.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$188.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$155.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$155.23
|
| Rate for Payer: Multiplan Commercial |
$166.32
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
| Rate for Payer: Riverside University Health System MISP |
$88.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.88
|
| Rate for Payer: United Healthcare All Other HMO |
$110.88
|
| Rate for Payer: United Healthcare HMO Rider |
$110.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.50
|
| Rate for Payer: Vantage Medical Group Senior |
$188.50
|
|
|
HC CATH WHISTLE TIP 10-12FR
|
Facility
|
OP
|
$11.73
|
|
| Hospital Charge Code |
901601347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.82
|
| Rate for Payer: Blue Shield of California Commercial |
$7.44
|
| Rate for Payer: Blue Shield of California EPN |
$4.68
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Cigna of CA HMO |
$7.51
|
| Rate for Payer: Cigna of CA PPO |
$8.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.21
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
| Rate for Payer: Riverside University Health System MISP |
$4.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.87
|
| Rate for Payer: United Healthcare All Other HMO |
$5.87
|
| Rate for Payer: United Healthcare HMO Rider |
$5.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9.97
|
|
|
HC CATH WHISTLE TIP 10-12FR
|
Facility
|
IP
|
$11.73
|
|
| Hospital Charge Code |
901601347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
|
HC CATH WHISTLE TIP 14-16FR
|
Facility
|
OP
|
$11.73
|
|
| Hospital Charge Code |
901601348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.82
|
| Rate for Payer: Blue Shield of California Commercial |
$7.44
|
| Rate for Payer: Blue Shield of California EPN |
$4.68
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Cigna of CA HMO |
$7.51
|
| Rate for Payer: Cigna of CA PPO |
$8.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.21
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
| Rate for Payer: Riverside University Health System MISP |
$4.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.87
|
| Rate for Payer: United Healthcare All Other HMO |
$5.87
|
| Rate for Payer: United Healthcare HMO Rider |
$5.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9.97
|
|
|
HC CATH WHISTLE TIP 14-16FR
|
Facility
|
IP
|
$11.73
|
|
| Hospital Charge Code |
901601348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
|
HC CATH WHISTLE TIP 8FR
|
Facility
|
IP
|
$11.73
|
|
| Hospital Charge Code |
901601473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
|
HC CATH WHISTLE TIP 8FR
|
Facility
|
OP
|
$11.73
|
|
| Hospital Charge Code |
901601473
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.82
|
| Rate for Payer: Blue Shield of California Commercial |
$7.44
|
| Rate for Payer: Blue Shield of California EPN |
$4.68
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Cigna of CA HMO |
$7.51
|
| Rate for Payer: Cigna of CA PPO |
$8.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.21
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
| Rate for Payer: Riverside University Health System MISP |
$4.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.87
|
| Rate for Payer: United Healthcare All Other HMO |
$5.87
|
| Rate for Payer: United Healthcare HMO Rider |
$5.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9.97
|
|
|
HC CATH WINGMAN CROSSING
|
Facility
|
OP
|
$3,881.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909000020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$23,685.15 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23,685.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,134.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,910.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,879.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,257.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,460.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,548.52
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,104.80
|
| Rate for Payer: Cigna of CA HMO |
$2,483.84
|
| Rate for Payer: Cigna of CA PPO |
$2,871.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,298.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,298.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,716.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,492.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,464.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,408.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,289.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,716.70
|
| Rate for Payer: Multiplan Commercial |
$2,910.75
|
| Rate for Payer: Networks By Design Commercial |
$2,522.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
| Rate for Payer: Riverside University Health System MISP |
$1,552.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,328.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,328.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,940.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,940.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,940.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,940.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Senior |
$3,298.85
|
|
|
HC CATH WINGMAN CROSSING
|
Facility
|
IP
|
$3,881.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909000020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$3,492.90 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,104.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,716.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,492.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,464.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,289.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$776.20
|
| Rate for Payer: Multiplan Commercial |
$2,910.75
|
| Rate for Payer: Networks By Design Commercial |
$2,522.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
|
|
HC CAVERNOSGRAPHY INJECTION
|
Facility
|
IP
|
$469.00
|
|
|
Service Code
|
CPT 54230
|
| Hospital Charge Code |
909080039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$422.10 |
| Rate for Payer: Adventist Health Commercial |
$93.80
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Central Health Plan Commercial |
$375.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$328.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.60
|
| Rate for Payer: EPIC Health Plan Senior |
$187.60
|
| Rate for Payer: Galaxy Health WC |
$398.65
|
| Rate for Payer: Global Benefits Group Commercial |
$281.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$351.75
|
| Rate for Payer: Networks By Design Commercial |
$304.85
|
| Rate for Payer: Prime Health Services Commercial |
$398.65
|
|
|
HC CAVERNOSGRAPHY INJECTION
|
Facility
|
OP
|
$469.00
|
|
|
Service Code
|
CPT 54230
|
| Hospital Charge Code |
909080039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$93.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$398.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$272.82
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Cash Price |
$211.05
|
| Rate for Payer: Central Health Plan Commercial |
$375.20
|
| Rate for Payer: Cigna of CA HMO |
$300.16
|
| Rate for Payer: Cigna of CA PPO |
$347.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$398.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$398.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$398.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$328.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.60
|
| Rate for Payer: EPIC Health Plan Senior |
$187.60
|
| Rate for Payer: Galaxy Health WC |
$398.65
|
| Rate for Payer: Global Benefits Group Commercial |
$281.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$105.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$328.30
|
| Rate for Payer: Multiplan Commercial |
$351.75
|
| Rate for Payer: Networks By Design Commercial |
$304.85
|
| Rate for Payer: Prime Health Services Commercial |
$398.65
|
| Rate for Payer: Riverside University Health System MISP |
$187.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$398.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$398.65
|
| Rate for Payer: Vantage Medical Group Senior |
$398.65
|
|
|
HC CAVILON BARRIER WAND 1ML
|
Facility
|
IP
|
$5.90
|
|
|
Service Code
|
CPT A6250
|
| Hospital Charge Code |
901698609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$5.31 |
| Rate for Payer: Adventist Health Commercial |
$1.18
|
| Rate for Payer: Cash Price |
$2.66
|
| Rate for Payer: Central Health Plan Commercial |
$4.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.36
|
| Rate for Payer: EPIC Health Plan Senior |
$2.36
|
| Rate for Payer: Galaxy Health WC |
$5.01
|
| Rate for Payer: Global Benefits Group Commercial |
$3.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Multiplan Commercial |
$4.42
|
| Rate for Payer: Networks By Design Commercial |
$3.83
|
| Rate for Payer: Prime Health Services Commercial |
$5.01
|
|
