|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
IP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Cash Price |
$2,990.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,366.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
OP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,302.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,990.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,078.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,633.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,193.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,322.62
|
| Rate for Payer: Blue Shield of California EPN |
$2,169.76
|
| Rate for Payer: Cash Price |
$2,990.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: Cigna of CA HMO |
$3,480.32
|
| Rate for Payer: Cigna of CA PPO |
$4,024.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,622.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: InnovAge PACE Commercial |
$2,719.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,366.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,806.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,806.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,175.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,262.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,262.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,719.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Senior |
$4,622.30
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
IP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$112.04 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Cash Price |
$68.47
|
| Rate for Payer: Central Health Plan Commercial |
$99.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.90
|
| Rate for Payer: Multiplan Commercial |
$93.37
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
OP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$112.04 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.11
|
| Rate for Payer: Blue Shield of California Commercial |
$76.06
|
| Rate for Payer: Blue Shield of California EPN |
$49.67
|
| Rate for Payer: Cash Price |
$68.47
|
| Rate for Payer: Central Health Plan Commercial |
$99.59
|
| Rate for Payer: Cigna of CA HMO |
$79.67
|
| Rate for Payer: Cigna of CA PPO |
$92.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.04
|
| Rate for Payer: InnovAge PACE Commercial |
$62.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.14
|
| Rate for Payer: Multiplan Commercial |
$93.37
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
| Rate for Payer: Riverside University Health System MISP |
$49.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.24
|
| Rate for Payer: United Healthcare All Other HMO |
$62.24
|
| Rate for Payer: United Healthcare HMO Rider |
$62.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.82
|
| Rate for Payer: Vantage Medical Group Senior |
$105.82
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
IP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
OP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.19
|
| Rate for Payer: Blue Shield of California Commercial |
$39.73
|
| Rate for Payer: Blue Shield of California EPN |
$25.95
|
| Rate for Payer: Cash Price |
$35.77
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: Cigna of CA HMO |
$41.62
|
| Rate for Payer: Cigna of CA PPO |
$48.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: InnovAge PACE Commercial |
$32.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.52
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Riverside University Health System MISP |
$26.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.52
|
| Rate for Payer: United Healthcare All Other HMO |
$32.52
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.28
|
| Rate for Payer: Vantage Medical Group Senior |
$55.28
|
|
|
HC CATH PWR PICC 4.5FR 45CM
|
Facility
|
OP
|
$1,367.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.47 |
| Max. Negotiated Rate |
$1,230.62 |
| Rate for Payer: Adventist Health Commercial |
$273.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,025.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$624.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$757.10
|
| Rate for Payer: Blue Shield of California Commercial |
$1,056.96
|
| Rate for Payer: Blue Shield of California EPN |
$689.14
|
| Rate for Payer: Cash Price |
$752.04
|
| Rate for Payer: Central Health Plan Commercial |
$1,093.88
|
| Rate for Payer: Cigna of CA HMO |
$957.14
|
| Rate for Payer: Cigna of CA PPO |
$957.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,162.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,162.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.94
|
| Rate for Payer: EPIC Health Plan Senior |
$546.94
|
| Rate for Payer: Galaxy Health WC |
$1,162.25
|
| Rate for Payer: Global Benefits Group Commercial |
$820.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,230.62
|
| Rate for Payer: InnovAge PACE Commercial |
$683.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$912.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$957.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$957.14
|
| Rate for Payer: Multiplan Commercial |
$1,025.51
|
| Rate for Payer: Networks By Design Commercial |
$683.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,162.25
|
| Rate for Payer: Riverside University Health System MISP |
$546.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$820.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$820.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$513.17
|
| Rate for Payer: United Healthcare All Other HMO |
$499.49
|
| Rate for Payer: United Healthcare HMO Rider |
$488.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$447.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,162.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,162.25
|
|
|
HC CATH PWR PICC 4.5FR 45CM
|
Facility
|
IP
|
$1,367.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.47 |
| Max. Negotiated Rate |
$1,230.62 |
| Rate for Payer: Adventist Health Commercial |
$273.47
|
| Rate for Payer: Blue Shield of California Commercial |
$1,056.96
|
| Rate for Payer: Blue Shield of California EPN |
$689.14
|
| Rate for Payer: Cash Price |
$752.04
|
| Rate for Payer: Central Health Plan Commercial |
$1,093.88
|
| Rate for Payer: Cigna of CA HMO |
$957.14
|
| Rate for Payer: Cigna of CA PPO |
$957.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.94
|
| Rate for Payer: EPIC Health Plan Senior |
$546.94
|
| Rate for Payer: Galaxy Health WC |
$1,162.25
|
| Rate for Payer: Global Benefits Group Commercial |
$820.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,230.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$912.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$273.47
|
| Rate for Payer: Multiplan Commercial |
$1,025.51
|
| Rate for Payer: Networks By Design Commercial |
$683.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,162.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$513.17
|
| Rate for Payer: United Healthcare All Other HMO |
$499.49
|
| Rate for Payer: United Healthcare HMO Rider |
$488.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$447.81
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
IP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Blue Shield of California Commercial |
$1,019.02
|
| Rate for Payer: Blue Shield of California EPN |
$664.41
|
| Rate for Payer: Cash Price |
$725.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$816.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
OP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$725.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$988.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$601.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$729.93
|
| Rate for Payer: Blue Shield of California Commercial |
$1,019.02
|
| Rate for Payer: Blue Shield of California EPN |
$664.41
|
| Rate for Payer: Cash Price |
$725.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,120.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,120.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: InnovAge PACE Commercial |
$659.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$816.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$922.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$922.79
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: Riverside University Health System MISP |
$527.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$790.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$790.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,120.53
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
OP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$220.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.10
|
| Rate for Payer: Blue Shield of California Commercial |
$372.89
|
| Rate for Payer: Blue Shield of California EPN |
$243.12
|
| Rate for Payer: Cash Price |
$265.31
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: InnovAge PACE Commercial |
$241.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$337.67
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: Riverside University Health System MISP |
$192.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.03
|
| Rate for Payer: Vantage Medical Group Senior |
$410.03
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
IP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Blue Shield of California Commercial |
$372.89
|
| Rate for Payer: Blue Shield of California EPN |
$243.12
|
| Rate for Payer: Cash Price |
$265.31
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$94.62
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Adventist Health Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$52.04
|
| Rate for Payer: Central Health Plan Commercial |
$75.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.85
|
| Rate for Payer: EPIC Health Plan Senior |
$37.85
|
| Rate for Payer: Galaxy Health WC |
$80.43
|
| Rate for Payer: Global Benefits Group Commercial |
$56.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.92
|
| Rate for Payer: Multiplan Commercial |
$70.97
|
| Rate for Payer: Networks By Design Commercial |
$61.50
|
| Rate for Payer: Prime Health Services Commercial |
$80.43
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Cash Price |
$119.62
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$94.62
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Adventist Health Commercial |
$18.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$70.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.57
|
| Rate for Payer: Blue Shield of California Commercial |
$57.81
|
| Rate for Payer: Blue Shield of California EPN |
$37.75
|
| Rate for Payer: Cash Price |
$52.04
|
| Rate for Payer: Central Health Plan Commercial |
$75.70
|
| Rate for Payer: Cigna of CA HMO |
$60.56
|
| Rate for Payer: Cigna of CA PPO |
$70.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$80.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.85
|
| Rate for Payer: EPIC Health Plan Senior |
$37.85
|
| Rate for Payer: Galaxy Health WC |
$80.43
|
| Rate for Payer: Global Benefits Group Commercial |
$56.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.16
|
| Rate for Payer: InnovAge PACE Commercial |
$47.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.23
|
| Rate for Payer: Multiplan Commercial |
$70.97
|
| Rate for Payer: Networks By Design Commercial |
$61.50
|
| Rate for Payer: Prime Health Services Commercial |
$80.43
|
| Rate for Payer: Riverside University Health System MISP |
$37.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.31
|
| Rate for Payer: United Healthcare All Other HMO |
$47.31
|
| Rate for Payer: United Healthcare HMO Rider |
$47.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.43
|
| Rate for Payer: Vantage Medical Group Senior |
$80.43
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.73
|
| Rate for Payer: Blue Shield of California Commercial |
$132.89
|
| Rate for Payer: Blue Shield of California EPN |
$86.78
|
| Rate for Payer: Cash Price |
$119.62
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: Cigna of CA HMO |
$139.19
|
| Rate for Payer: Cigna of CA PPO |
$160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: InnovAge PACE Commercial |
$108.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.24
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
| Rate for Payer: Riverside University Health System MISP |
$87.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.75
|
| Rate for Payer: United Healthcare All Other HMO |
$108.75
|
| Rate for Payer: United Healthcare HMO Rider |
$108.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.87
|
| Rate for Payer: Vantage Medical Group Senior |
$184.87
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
IP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$334.71 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Cash Price |
$204.55
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Multiplan Commercial |
$278.93
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
OP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$334.71 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$225.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$204.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$278.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$180.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.42
|
| Rate for Payer: Blue Shield of California Commercial |
$227.23
|
| Rate for Payer: Blue Shield of California EPN |
$148.39
|
| Rate for Payer: Cash Price |
$204.55
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: Cigna of CA HMO |
$238.02
|
| Rate for Payer: Cigna of CA PPO |
$275.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$316.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$316.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$316.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: InnovAge PACE Commercial |
$185.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$260.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$260.33
|
| Rate for Payer: Multiplan Commercial |
$278.93
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
| Rate for Payer: Riverside University Health System MISP |
$148.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$185.95
|
| Rate for Payer: United Healthcare All Other HMO |
$185.95
|
| Rate for Payer: United Healthcare HMO Rider |
$185.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$316.12
|
| Rate for Payer: Vantage Medical Group Senior |
$316.12
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
OP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$404.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$366.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$499.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$322.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$391.41
|
| Rate for Payer: Blue Shield of California Commercial |
$407.20
|
| Rate for Payer: Blue Shield of California EPN |
$265.91
|
| Rate for Payer: Cash Price |
$366.55
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: Cigna of CA HMO |
$426.53
|
| Rate for Payer: Cigna of CA PPO |
$493.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$566.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$566.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: InnovAge PACE Commercial |
$333.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$412.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.51
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
| Rate for Payer: Riverside University Health System MISP |
$266.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.23
|
| Rate for Payer: United Healthcare All Other HMO |
$333.23
|
| Rate for Payer: United Healthcare HMO Rider |
$333.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$333.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.48
|
| Rate for Payer: Vantage Medical Group Senior |
$566.48
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
IP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Cash Price |
$366.55
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$412.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
|
|
HC CATH RESCUE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
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 RESCUE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
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 RESCUE SUCTION OMNEOTECH
|
Facility
|
IP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Cash Price |
$205.76
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$231.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Multiplan Commercial |
$280.57
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
OP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$227.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.71
|
| Rate for Payer: Blue Shield of California Commercial |
$228.58
|
| Rate for Payer: Blue Shield of California EPN |
$149.27
|
| Rate for Payer: Cash Price |
$205.76
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: Cigna of CA HMO |
$239.42
|
| Rate for Payer: Cigna of CA PPO |
$276.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: InnovAge PACE Commercial |
$187.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$231.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.87
|
| Rate for Payer: Multiplan Commercial |
$280.57
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
| Rate for Payer: Riverside University Health System MISP |
$149.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$187.05
|
| Rate for Payer: United Healthcare All Other HMO |
$187.05
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$187.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.99
|
|
