|
HC CATH SUCTION KIT 12FR
|
Facility
|
IP
|
$3.03
|
|
| Hospital Charge Code |
901698862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.73 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$2.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Senior |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: Multiplan Commercial |
$2.27
|
| Rate for Payer: Networks By Design Commercial |
$1.97
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
|
|
HC CATH SUCTION KIT 12FR
|
Facility
|
OP
|
$3.03
|
|
| Hospital Charge Code |
901698862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.73 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.78
|
| Rate for Payer: Blue Shield of California Commercial |
$1.85
|
| Rate for Payer: Blue Shield of California EPN |
$1.21
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$2.42
|
| Rate for Payer: Cigna of CA HMO |
$1.94
|
| Rate for Payer: Cigna of CA PPO |
$2.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Senior |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.73
|
| Rate for Payer: InnovAge PACE Commercial |
$1.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$2.27
|
| Rate for Payer: Networks By Design Commercial |
$1.97
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: Riverside University Health System MISP |
$1.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.51
|
| Rate for Payer: United Healthcare All Other HMO |
$1.51
|
| Rate for Payer: United Healthcare HMO Rider |
$1.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.58
|
| Rate for Payer: Vantage Medical Group Senior |
$2.58
|
|
|
HC CATH SUCTION KIT 5FR 21IN
|
Facility
|
OP
|
$49.28
|
|
| Hospital Charge Code |
901698546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$44.35 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.94
|
| Rate for Payer: Blue Shield of California Commercial |
$30.11
|
| Rate for Payer: Blue Shield of California EPN |
$19.66
|
| Rate for Payer: Cash Price |
$27.10
|
| Rate for Payer: Central Health Plan Commercial |
$39.42
|
| Rate for Payer: Cigna of CA HMO |
$31.54
|
| Rate for Payer: Cigna of CA PPO |
$36.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.35
|
| Rate for Payer: InnovAge PACE Commercial |
$24.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$36.96
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
| Rate for Payer: Riverside University Health System MISP |
$19.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.64
|
| Rate for Payer: United Healthcare All Other HMO |
$24.64
|
| Rate for Payer: United Healthcare HMO Rider |
$24.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.89
|
| Rate for Payer: Vantage Medical Group Senior |
$41.89
|
|
|
HC CATH SUCTION KIT 5FR 21IN
|
Facility
|
IP
|
$49.28
|
|
| Hospital Charge Code |
901698546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$44.35 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Cash Price |
$27.10
|
| Rate for Payer: Central Health Plan Commercial |
$39.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.86
|
| Rate for Payer: Multiplan Commercial |
$36.96
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
|
|
HC CATH SUCTION ORAL 8FR
|
Facility
|
IP
|
$2.71
|
|
| Hospital Charge Code |
901604576
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Adventist Health Commercial |
$0.54
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Central Health Plan Commercial |
$2.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.08
|
| Rate for Payer: EPIC Health Plan Senior |
$1.08
|
| Rate for Payer: Galaxy Health WC |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.54
|
| Rate for Payer: Multiplan Commercial |
$2.03
|
| Rate for Payer: Networks By Design Commercial |
$1.76
|
| Rate for Payer: Prime Health Services Commercial |
$2.30
|
|
|
HC CATH SUCTION ORAL 8FR
|
Facility
|
OP
|
$2.71
|
|
| Hospital Charge Code |
901604576
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Adventist Health Commercial |
$0.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1.66
|
| Rate for Payer: Blue Shield of California EPN |
$1.08
|
| Rate for Payer: Cash Price |
$1.49
|
| Rate for Payer: Central Health Plan Commercial |
$2.17
|
| Rate for Payer: Cigna of CA HMO |
$1.73
|
| Rate for Payer: Cigna of CA PPO |
$2.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.08
|
| Rate for Payer: EPIC Health Plan Senior |
$1.08
|
| Rate for Payer: Galaxy Health WC |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.90
|
| Rate for Payer: Multiplan Commercial |
$2.03
|
| Rate for Payer: Networks By Design Commercial |
$1.76
|
| Rate for Payer: Prime Health Services Commercial |
$2.30
|
| Rate for Payer: Riverside University Health System MISP |
$1.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1.35
|
| Rate for Payer: United Healthcare HMO Rider |
$1.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2.30
|
|
|
HC CATH SUCTION RED POLY 10FR
|
Facility
|
IP
|
$8.61
|
|
| Hospital Charge Code |
901698415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$7.75 |
| Rate for Payer: Adventist Health Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$4.74
|
| Rate for Payer: Central Health Plan Commercial |
$6.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3.44
|
| Rate for Payer: Galaxy Health WC |
$7.32
|
| Rate for Payer: Global Benefits Group Commercial |
$5.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.72
|
| Rate for Payer: Multiplan Commercial |
$6.46
|
| Rate for Payer: Networks By Design Commercial |
$5.60
|
| Rate for Payer: Prime Health Services Commercial |
$7.32
|
|
|
HC CATH SUCTION RED POLY 10FR
|
Facility
|
OP
|
$8.61
|
|
| Hospital Charge Code |
901698415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$7.75 |
| Rate for Payer: Adventist Health Commercial |
$1.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.06
|
| Rate for Payer: Blue Shield of California Commercial |
$5.26
|
| Rate for Payer: Blue Shield of California EPN |
$3.44
|
| Rate for Payer: Cash Price |
$4.74
|
| Rate for Payer: Central Health Plan Commercial |
$6.89
|
| Rate for Payer: Cigna of CA HMO |
$5.51
|
| Rate for Payer: Cigna of CA PPO |
$6.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3.44
|
| Rate for Payer: Galaxy Health WC |
$7.32
|
| Rate for Payer: Global Benefits Group Commercial |
$5.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.75
|
| Rate for Payer: InnovAge PACE Commercial |
$4.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.03
|
| Rate for Payer: Multiplan Commercial |
$6.46
|
| Rate for Payer: Networks By Design Commercial |
$5.60
|
| Rate for Payer: Prime Health Services Commercial |
$7.32
|
| Rate for Payer: Riverside University Health System MISP |
$3.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.30
|
| Rate for Payer: United Healthcare All Other HMO |
$4.30
|
| Rate for Payer: United Healthcare HMO Rider |
$4.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.32
|
| Rate for Payer: Vantage Medical Group Senior |
$7.32
|
|
|
HC CATH SUCTION RED POLY 14FR
|
Facility
|
OP
|
$6.56
|
|
| Hospital Charge Code |
901698416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Adventist Health Commercial |
$1.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.85
|
| Rate for Payer: Blue Shield of California Commercial |
$4.01
|
| Rate for Payer: Blue Shield of California EPN |
$2.62
|
| Rate for Payer: Cash Price |
$3.61
|
| Rate for Payer: Central Health Plan Commercial |
$5.25
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$4.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.62
|
| Rate for Payer: EPIC Health Plan Senior |
$2.62
|
| Rate for Payer: Galaxy Health WC |
$5.58
|
| Rate for Payer: Global Benefits Group Commercial |
$3.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.90
|
| Rate for Payer: InnovAge PACE Commercial |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.59
|
| Rate for Payer: Multiplan Commercial |
$4.92
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$5.58
|
| Rate for Payer: Riverside University Health System MISP |
$2.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.28
|
| Rate for Payer: United Healthcare All Other HMO |
$3.28
|
| Rate for Payer: United Healthcare HMO Rider |
$3.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.58
|
| Rate for Payer: Vantage Medical Group Senior |
$5.58
|
|
|
HC CATH SUCTION RED POLY 14FR
|
Facility
|
IP
|
$6.56
|
|
| Hospital Charge Code |
901698416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Adventist Health Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$3.61
|
| Rate for Payer: Central Health Plan Commercial |
$5.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.62
|
| Rate for Payer: EPIC Health Plan Senior |
$2.62
|
| Rate for Payer: Galaxy Health WC |
$5.58
|
| Rate for Payer: Global Benefits Group Commercial |
$3.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.31
|
| Rate for Payer: Multiplan Commercial |
$4.92
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$5.58
|
|
|
HC CATH SUCTION REPLOGLE 10FR
|
Facility
|
OP
|
$66.09
|
|
| Hospital Charge Code |
901698411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$59.48 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.81
|
| Rate for Payer: Blue Shield of California Commercial |
$40.38
|
| Rate for Payer: Blue Shield of California EPN |
$26.37
|
| Rate for Payer: Cash Price |
$36.35
|
| Rate for Payer: Central Health Plan Commercial |
$52.87
|
| Rate for Payer: Cigna of CA HMO |
$42.30
|
| Rate for Payer: Cigna of CA PPO |
$48.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.48
|
| Rate for Payer: InnovAge PACE Commercial |
$33.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.26
|
| Rate for Payer: Multiplan Commercial |
$49.57
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
| Rate for Payer: Riverside University Health System MISP |
$26.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.05
|
| Rate for Payer: United Healthcare All Other HMO |
$33.05
|
| Rate for Payer: United Healthcare HMO Rider |
$33.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.18
|
| Rate for Payer: Vantage Medical Group Senior |
$56.18
|
|
|
HC CATH SUCTION REPLOGLE 10FR
|
Facility
|
IP
|
$66.09
|
|
| Hospital Charge Code |
901698411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$59.48 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Cash Price |
$36.35
|
| Rate for Payer: Central Health Plan Commercial |
$52.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.22
|
| Rate for Payer: Multiplan Commercial |
$49.57
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
|
|
HC CATH SUREFIRE MICROCATH
|
Facility
|
OP
|
$9,574.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909001887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,914.80 |
| Max. Negotiated Rate |
$8,616.60 |
| Rate for Payer: Adventist Health Commercial |
$1,914.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,265.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,180.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,371.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,301.12
|
| Rate for Payer: Blue Shield of California Commercial |
$7,400.70
|
| Rate for Payer: Blue Shield of California EPN |
$4,825.30
|
| Rate for Payer: Cash Price |
$5,265.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,659.20
|
| Rate for Payer: Cigna of CA HMO |
$6,701.80
|
| Rate for Payer: Cigna of CA PPO |
$6,701.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,137.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,137.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,829.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,829.60
|
| Rate for Payer: Galaxy Health WC |
$8,137.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,744.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,616.60
|
| Rate for Payer: InnovAge PACE Commercial |
$4,787.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,385.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,647.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,926.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,914.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,701.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,701.80
|
| Rate for Payer: Multiplan Commercial |
$7,180.50
|
| Rate for Payer: Networks By Design Commercial |
$4,787.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,137.90
|
| Rate for Payer: Riverside University Health System MISP |
$3,829.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,744.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,744.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,593.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3,497.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,421.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,135.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,137.90
|
| Rate for Payer: Vantage Medical Group Senior |
$8,137.90
|
|
|
HC CATH SUREFIRE MICROCATH
|
Facility
|
IP
|
$9,574.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909001887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,914.80 |
| Max. Negotiated Rate |
$8,616.60 |
| Rate for Payer: Adventist Health Commercial |
$1,914.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,400.70
|
| Rate for Payer: Blue Shield of California EPN |
$4,825.30
|
| Rate for Payer: Cash Price |
$5,265.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,659.20
|
| Rate for Payer: Cigna of CA HMO |
$6,701.80
|
| Rate for Payer: Cigna of CA PPO |
$6,701.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,829.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,829.60
|
| Rate for Payer: Galaxy Health WC |
$8,137.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,744.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,616.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,385.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,647.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,926.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,914.80
|
| Rate for Payer: Multiplan Commercial |
$7,180.50
|
| Rate for Payer: Networks By Design Commercial |
$4,787.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,137.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,593.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3,497.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,421.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,135.49
|
|
|
HC CATH SWAN CONT.8FR NON HEPARIN
|
Facility
|
IP
|
$1,858.40
|
|
| Hospital Charge Code |
901607286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$371.68 |
| Max. Negotiated Rate |
$1,672.56 |
| Rate for Payer: Adventist Health Commercial |
$371.68
|
| Rate for Payer: Cash Price |
$1,022.12
|
| Rate for Payer: Central Health Plan Commercial |
$1,486.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.36
|
| Rate for Payer: EPIC Health Plan Senior |
$743.36
|
| Rate for Payer: Galaxy Health WC |
$1,579.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,672.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.68
|
| Rate for Payer: Multiplan Commercial |
$1,393.80
|
| Rate for Payer: Networks By Design Commercial |
$1,207.96
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.64
|
|
|
HC CATH SWAN CONT.8FR NON HEPARIN
|
Facility
|
OP
|
$1,858.40
|
|
| Hospital Charge Code |
901607286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$371.68 |
| Max. Negotiated Rate |
$1,672.56 |
| Rate for Payer: Adventist Health Commercial |
$371.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,128.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,022.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,393.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$899.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,091.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,135.48
|
| Rate for Payer: Blue Shield of California EPN |
$741.50
|
| Rate for Payer: Cash Price |
$1,022.12
|
| Rate for Payer: Central Health Plan Commercial |
$1,486.72
|
| Rate for Payer: Cigna of CA HMO |
$1,189.38
|
| Rate for Payer: Cigna of CA PPO |
$1,375.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,579.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,579.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.36
|
| Rate for Payer: EPIC Health Plan Senior |
$743.36
|
| Rate for Payer: Galaxy Health WC |
$1,579.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,672.56
|
| Rate for Payer: InnovAge PACE Commercial |
$929.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,300.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,300.88
|
| Rate for Payer: Multiplan Commercial |
$1,393.80
|
| Rate for Payer: Networks By Design Commercial |
$1,207.96
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.64
|
| Rate for Payer: Riverside University Health System MISP |
$743.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,115.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,115.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$929.20
|
| Rate for Payer: United Healthcare All Other HMO |
$929.20
|
| Rate for Payer: United Healthcare HMO Rider |
$929.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$929.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,579.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,579.64
|
|
|
HC CATH SWAN-GANZ 7.5FR 110CM
|
Facility
|
IP
|
$1,598.22
|
|
| Hospital Charge Code |
901698772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$319.64 |
| Max. Negotiated Rate |
$1,438.40 |
| Rate for Payer: Adventist Health Commercial |
$319.64
|
| Rate for Payer: Cash Price |
$879.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,278.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$639.29
|
| Rate for Payer: EPIC Health Plan Senior |
$639.29
|
| Rate for Payer: Galaxy Health WC |
$1,358.49
|
| Rate for Payer: Global Benefits Group Commercial |
$958.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,438.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,066.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$608.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$989.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$319.64
|
| Rate for Payer: Multiplan Commercial |
$1,198.66
|
| Rate for Payer: Networks By Design Commercial |
$1,038.84
|
| Rate for Payer: Prime Health Services Commercial |
$1,358.49
|
|
|
HC CATH SWAN-GANZ 7.5FR 110CM
|
Facility
|
OP
|
$1,598.22
|
|
| Hospital Charge Code |
901698772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$319.64 |
| Max. Negotiated Rate |
$1,438.40 |
| Rate for Payer: Adventist Health Commercial |
$319.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$970.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$879.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,198.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$773.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$938.63
|
| Rate for Payer: Blue Shield of California Commercial |
$976.51
|
| Rate for Payer: Blue Shield of California EPN |
$637.69
|
| Rate for Payer: Cash Price |
$879.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,278.58
|
| Rate for Payer: Cigna of CA HMO |
$1,022.86
|
| Rate for Payer: Cigna of CA PPO |
$1,182.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,358.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,358.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$639.29
|
| Rate for Payer: EPIC Health Plan Senior |
$639.29
|
| Rate for Payer: Galaxy Health WC |
$1,358.49
|
| Rate for Payer: Global Benefits Group Commercial |
$958.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,438.40
|
| Rate for Payer: InnovAge PACE Commercial |
$799.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,066.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$608.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$989.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$319.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,118.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,118.75
|
| Rate for Payer: Multiplan Commercial |
$1,198.66
|
| Rate for Payer: Networks By Design Commercial |
$1,038.84
|
| Rate for Payer: Prime Health Services Commercial |
$1,358.49
|
| Rate for Payer: Riverside University Health System MISP |
$639.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$958.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$958.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$799.11
|
| Rate for Payer: United Healthcare All Other HMO |
$799.11
|
| Rate for Payer: United Healthcare HMO Rider |
$799.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$799.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,358.49
|
| Rate for Payer: Vantage Medical Group Senior |
$1,358.49
|
|
|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
|
OP
|
$1,093.14
|
|
| Hospital Charge Code |
901698451
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$218.63 |
| Max. Negotiated Rate |
$983.83 |
| Rate for Payer: Adventist Health Commercial |
$218.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$663.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$929.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$819.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$529.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$642.00
|
| Rate for Payer: Blue Shield of California Commercial |
$667.91
|
| Rate for Payer: Blue Shield of California EPN |
$436.16
|
| Rate for Payer: Cash Price |
$601.23
|
| Rate for Payer: Central Health Plan Commercial |
$874.51
|
| Rate for Payer: Cigna of CA HMO |
$699.61
|
| Rate for Payer: Cigna of CA PPO |
$808.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$929.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$929.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$929.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.26
|
| Rate for Payer: EPIC Health Plan Senior |
$437.26
|
| Rate for Payer: Galaxy Health WC |
$929.17
|
| Rate for Payer: Global Benefits Group Commercial |
$655.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$983.83
|
| Rate for Payer: InnovAge PACE Commercial |
$546.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$416.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$676.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$765.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$765.20
|
| Rate for Payer: Multiplan Commercial |
$819.86
|
| Rate for Payer: Networks By Design Commercial |
$710.54
|
| Rate for Payer: Prime Health Services Commercial |
$929.17
|
| Rate for Payer: Riverside University Health System MISP |
$437.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$655.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$655.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$546.57
|
| Rate for Payer: United Healthcare All Other HMO |
$546.57
|
| Rate for Payer: United Healthcare HMO Rider |
$546.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$546.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$929.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$929.17
|
| Rate for Payer: Vantage Medical Group Senior |
$929.17
|
|
|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
|
IP
|
$1,093.14
|
|
| Hospital Charge Code |
901698451
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$218.63 |
| Max. Negotiated Rate |
$983.83 |
| Rate for Payer: Adventist Health Commercial |
$218.63
|
| Rate for Payer: Cash Price |
$601.23
|
| Rate for Payer: Central Health Plan Commercial |
$874.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.26
|
| Rate for Payer: EPIC Health Plan Senior |
$437.26
|
| Rate for Payer: Galaxy Health WC |
$929.17
|
| Rate for Payer: Global Benefits Group Commercial |
$655.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$983.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$729.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$416.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$676.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.63
|
| Rate for Payer: Multiplan Commercial |
$819.86
|
| Rate for Payer: Networks By Design Commercial |
$710.54
|
| Rate for Payer: Prime Health Services Commercial |
$929.17
|
|
|
HC CATH SWANZ GANZ TL
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901607753
|
|
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 SWANZ GANZ TL
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901607753
|
|
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 TERUMO FINECROSS
|
Facility
|
IP
|
$943.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$848.70 |
| Rate for Payer: Adventist Health Commercial |
$188.60
|
| Rate for Payer: Blue Shield of California Commercial |
$728.94
|
| Rate for Payer: Blue Shield of California EPN |
$475.27
|
| Rate for Payer: Cash Price |
$518.65
|
| Rate for Payer: Central Health Plan Commercial |
$754.40
|
| Rate for Payer: Cigna of CA HMO |
$660.10
|
| Rate for Payer: Cigna of CA PPO |
$660.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.20
|
| Rate for Payer: EPIC Health Plan Senior |
$377.20
|
| Rate for Payer: Galaxy Health WC |
$801.55
|
| Rate for Payer: Global Benefits Group Commercial |
$565.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$848.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$359.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.60
|
| Rate for Payer: Multiplan Commercial |
$707.25
|
| Rate for Payer: Networks By Design Commercial |
$471.50
|
| Rate for Payer: Prime Health Services Commercial |
$801.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.91
|
| Rate for Payer: United Healthcare All Other HMO |
$344.48
|
| Rate for Payer: United Healthcare HMO Rider |
$337.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.83
|
|
|
HC CATH TERUMO FINECROSS
|
Facility
|
OP
|
$943.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$848.70 |
| Rate for Payer: Adventist Health Commercial |
$188.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$801.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$518.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$707.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$430.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.14
|
| Rate for Payer: Blue Shield of California Commercial |
$728.94
|
| Rate for Payer: Blue Shield of California EPN |
$475.27
|
| Rate for Payer: Cash Price |
$518.65
|
| Rate for Payer: Central Health Plan Commercial |
$754.40
|
| Rate for Payer: Cigna of CA HMO |
$660.10
|
| Rate for Payer: Cigna of CA PPO |
$660.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$801.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$801.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$801.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.20
|
| Rate for Payer: EPIC Health Plan Senior |
$377.20
|
| Rate for Payer: Galaxy Health WC |
$801.55
|
| Rate for Payer: Global Benefits Group Commercial |
$565.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$848.70
|
| Rate for Payer: InnovAge PACE Commercial |
$471.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$359.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$583.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$660.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$660.10
|
| Rate for Payer: Multiplan Commercial |
$707.25
|
| Rate for Payer: Networks By Design Commercial |
$471.50
|
| Rate for Payer: Prime Health Services Commercial |
$801.55
|
| Rate for Payer: Riverside University Health System MISP |
$377.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$565.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$565.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.91
|
| Rate for Payer: United Healthcare All Other HMO |
$344.48
|
| Rate for Payer: United Healthcare HMO Rider |
$337.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$801.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$801.55
|
| Rate for Payer: Vantage Medical Group Senior |
$801.55
|
|
|
HC CATH TERUMO HEARTRAIL III
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812420
|
|
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
|
|
