|
HC CATH MED ATTAIN VENOGRAM BAL 6215
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812489
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH MED ATTAIN VENOGRAM BAL 6215
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812489
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH MED GUIDE 6248DEL90D
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$530.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$423.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.30
|
| Rate for Payer: Blue Shield of California Commercial |
$534.01
|
| Rate for Payer: Blue Shield of California EPN |
$348.73
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: InnovAge PACE Commercial |
$437.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Riverside University Health System MISP |
$349.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH MED GUIDE 6248DEL90D
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Central Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$786.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.80
|
| Rate for Payer: Multiplan Commercial |
$655.50
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH MED HAWKONE ATHERECTOM
|
Facility
|
IP
|
$9,343.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
906812660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,868.60 |
| Max. Negotiated Rate |
$8,408.70 |
| Rate for Payer: Adventist Health Commercial |
$1,868.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,222.14
|
| Rate for Payer: Blue Shield of California EPN |
$4,708.87
|
| Rate for Payer: Cash Price |
$5,138.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,474.40
|
| Rate for Payer: Cigna of CA HMO |
$6,540.10
|
| Rate for Payer: Cigna of CA PPO |
$6,540.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,737.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,737.20
|
| Rate for Payer: Galaxy Health WC |
$7,941.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,605.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,408.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,231.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,559.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,783.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,868.60
|
| Rate for Payer: Multiplan Commercial |
$7,007.25
|
| Rate for Payer: Networks By Design Commercial |
$4,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,941.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,506.43
|
| Rate for Payer: United Healthcare All Other HMO |
$3,413.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,339.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,059.83
|
|
|
HC CATH MED HAWKONE ATHERECTOM
|
Facility
|
OP
|
$9,343.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
906812660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,868.60 |
| Max. Negotiated Rate |
$8,408.70 |
| Rate for Payer: Adventist Health Commercial |
$1,868.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,138.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,007.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,266.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,173.22
|
| Rate for Payer: Blue Shield of California Commercial |
$7,222.14
|
| Rate for Payer: Blue Shield of California EPN |
$4,708.87
|
| Rate for Payer: Cash Price |
$5,138.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,474.40
|
| Rate for Payer: Cigna of CA HMO |
$6,540.10
|
| Rate for Payer: Cigna of CA PPO |
$6,540.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,941.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,941.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,737.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,737.20
|
| Rate for Payer: Galaxy Health WC |
$7,941.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,605.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,408.70
|
| Rate for Payer: InnovAge PACE Commercial |
$4,671.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,231.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,559.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,783.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,868.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,540.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,540.10
|
| Rate for Payer: Multiplan Commercial |
$7,007.25
|
| Rate for Payer: Networks By Design Commercial |
$4,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,941.55
|
| Rate for Payer: Riverside University Health System MISP |
$3,737.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,605.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,605.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,506.43
|
| Rate for Payer: United Healthcare All Other HMO |
$3,413.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,339.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,059.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,941.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,941.55
|
|
|
HC CATH MED INDIVIDUAL GUIDE 6218A
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$474.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$378.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.27
|
| Rate for Payer: Blue Shield of California Commercial |
$477.80
|
| Rate for Payer: Blue Shield of California EPN |
$312.02
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$500.48
|
| Rate for Payer: Cigna of CA PPO |
$578.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: InnovAge PACE Commercial |
$391.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Riverside University Health System MISP |
$312.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC CATH MED INDIVIDUAL GUIDE 6218A
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$144.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.02
|
| Rate for Payer: Blue Shield of California Commercial |
$182.08
|
| Rate for Payer: Blue Shield of California EPN |
$118.90
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: InnovAge PACE Commercial |
$149.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Riverside University Health System MISP |
$119.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH MED LAUNCHER
|
Facility
|
OP
|
$377.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$228.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$221.41
|
| Rate for Payer: Blue Shield of California Commercial |
$230.35
|
| Rate for Payer: Blue Shield of California EPN |
$150.42
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: InnovAge PACE Commercial |
$188.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Riverside University Health System MISP |
$150.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH MED LAUNCHER
|
Facility
|
IP
|
$377.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH MED NIH
|
Facility
|
IP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC CATH MED NIH
|
Facility
|
OP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$322.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$398.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$257.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$311.86
|
| Rate for Payer: Blue Shield of California Commercial |
$324.44
|
| Rate for Payer: Blue Shield of California EPN |
$211.87
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$451.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: InnovAge PACE Commercial |
$265.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.70
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Riverside University Health System MISP |
$212.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$265.50
|
| Rate for Payer: United Healthcare All Other HMO |
$265.50
|
| Rate for Payer: United Healthcare HMO Rider |
$265.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC CATH MED RIGHTSITE C315HIS02
|
Facility
|
OP
|
$1,720.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$1,548.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$946.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,290.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$785.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$952.36
|
| Rate for Payer: Blue Shield of California Commercial |
$1,329.56
|
| Rate for Payer: Blue Shield of California EPN |
$866.88
|
| Rate for Payer: Cash Price |
$946.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,376.00
|
| Rate for Payer: Cigna of CA HMO |
$1,204.00
|
| Rate for Payer: Cigna of CA PPO |
$1,204.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,462.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,548.00
|
| Rate for Payer: InnovAge PACE Commercial |
$860.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,147.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$655.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,064.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,204.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,204.00
|
| Rate for Payer: Multiplan Commercial |
$1,290.00
|
| Rate for Payer: Networks By Design Commercial |
$860.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
| Rate for Payer: Riverside University Health System MISP |
$688.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,032.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,032.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$645.52
|
| Rate for Payer: United Healthcare All Other HMO |
$628.32
|
| Rate for Payer: United Healthcare HMO Rider |
$614.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,462.00
|
|
|
HC CATH MED RIGHTSITE C315HIS02
|
Facility
|
IP
|
$1,720.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$1,548.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,329.56
|
| Rate for Payer: Blue Shield of California EPN |
$866.88
|
| Rate for Payer: Cash Price |
$946.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,376.00
|
| Rate for Payer: Cigna of CA HMO |
$1,204.00
|
| Rate for Payer: Cigna of CA PPO |
$1,204.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,548.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,147.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$655.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,064.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.00
|
| Rate for Payer: Multiplan Commercial |
$1,290.00
|
| Rate for Payer: Networks By Design Commercial |
$860.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$645.52
|
| Rate for Payer: United Healthcare All Other HMO |
$628.32
|
| Rate for Payer: United Healthcare HMO Rider |
$614.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.30
|
|
|
HC CATH MED SELECTSITE C315
|
Facility
|
OP
|
$1,380.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,242.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$838.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$759.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,035.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$668.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$810.47
|
| Rate for Payer: Blue Shield of California Commercial |
$843.18
|
| Rate for Payer: Blue Shield of California EPN |
$550.62
|
| Rate for Payer: Cash Price |
$759.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,104.00
|
| Rate for Payer: Cigna of CA HMO |
$883.20
|
| Rate for Payer: Cigna of CA PPO |
$1,021.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,173.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,173.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,242.00
|
| Rate for Payer: InnovAge PACE Commercial |
$690.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$966.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$966.00
|
| Rate for Payer: Multiplan Commercial |
$1,035.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
| Rate for Payer: Riverside University Health System MISP |
$552.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$690.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$690.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,173.00
|
|
|
HC CATH MED SELECTSITE C315
|
Facility
|
IP
|
$1,380.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,242.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Cash Price |
$759.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,242.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.00
|
| Rate for Payer: Multiplan Commercial |
$1,035.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
|
|
HC CATH MED TRAILBLAZER ANGLE
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH MED TRAILBLAZER ANGLE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,159.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH MED TRAILBLAZER STRAIGHT
|
Facility
|
IP
|
$3,120.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$2,808.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,411.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,572.48
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Cigna of CA HMO |
$2,184.00
|
| Rate for Payer: Cigna of CA PPO |
$2,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,248.00
|
| Rate for Payer: Galaxy Health WC |
$2,652.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,808.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$624.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,560.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,652.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,170.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,139.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,021.80
|
|
|
HC CATH MED TRAILBLAZER STRAIGHT
|
Facility
|
OP
|
$3,120.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$2,808.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,716.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,340.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,424.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,727.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,411.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,572.48
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Cigna of CA HMO |
$2,184.00
|
| Rate for Payer: Cigna of CA PPO |
$2,184.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,652.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,652.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,248.00
|
| Rate for Payer: Galaxy Health WC |
$2,652.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,808.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,560.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$624.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,184.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,184.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,560.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,652.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,248.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,872.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,872.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,170.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,139.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,021.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,652.00
|
|
|
HC CATH MED VIANCE CROSSING
|
Facility
|
OP
|
$4,355.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$871.00 |
| Max. Negotiated Rate |
$3,919.50 |
| Rate for Payer: Adventist Health Commercial |
$871.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,644.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,395.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,266.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,108.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,557.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,660.91
|
| Rate for Payer: Blue Shield of California EPN |
$1,737.64
|
| Rate for Payer: Cash Price |
$2,395.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,484.00
|
| Rate for Payer: Cigna of CA HMO |
$2,787.20
|
| Rate for Payer: Cigna of CA PPO |
$3,222.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,701.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,701.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,742.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,742.00
|
| Rate for Payer: Galaxy Health WC |
$3,701.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,613.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,919.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,177.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,904.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,659.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,695.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,048.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,048.50
|
| Rate for Payer: Multiplan Commercial |
$3,266.25
|
| Rate for Payer: Networks By Design Commercial |
$2,830.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,701.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,742.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,613.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,613.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,177.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,177.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,177.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,177.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,701.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,701.75
|
|
|
HC CATH MED VIANCE CROSSING
|
Facility
|
IP
|
$4,355.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$871.00 |
| Max. Negotiated Rate |
$3,919.50 |
| Rate for Payer: Adventist Health Commercial |
$871.00
|
| Rate for Payer: Cash Price |
$2,395.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,742.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,742.00
|
| Rate for Payer: Galaxy Health WC |
$3,701.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,613.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,919.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,904.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,659.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,695.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$871.00
|
| Rate for Payer: Multiplan Commercial |
$3,266.25
|
| Rate for Payer: Networks By Design Commercial |
$2,830.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,701.75
|
|
|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
