|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
IP
|
$54.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$48.85 |
| Rate for Payer: Adventist Health Commercial |
$10.86
|
| Rate for Payer: Blue Shield of California Commercial |
$41.96
|
| Rate for Payer: Blue Shield of California EPN |
$27.36
|
| Rate for Payer: Cash Price |
$29.85
|
| Rate for Payer: Central Health Plan Commercial |
$43.42
|
| Rate for Payer: Cigna of CA HMO |
$38.00
|
| Rate for Payer: Cigna of CA PPO |
$38.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.71
|
| Rate for Payer: EPIC Health Plan Senior |
$21.71
|
| Rate for Payer: Galaxy Health WC |
$46.14
|
| Rate for Payer: Global Benefits Group Commercial |
$32.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$40.71
|
| Rate for Payer: Networks By Design Commercial |
$27.14
|
| Rate for Payer: Prime Health Services Commercial |
$46.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.37
|
| Rate for Payer: United Healthcare All Other HMO |
$19.83
|
| Rate for Payer: United Healthcare HMO Rider |
$19.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
IP
|
$80.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$72.40 |
| Rate for Payer: Adventist Health Commercial |
$16.09
|
| Rate for Payer: Blue Shield of California Commercial |
$62.18
|
| Rate for Payer: Blue Shield of California EPN |
$40.54
|
| Rate for Payer: Cash Price |
$44.24
|
| Rate for Payer: Central Health Plan Commercial |
$64.35
|
| Rate for Payer: Cigna of CA HMO |
$56.31
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.18
|
| Rate for Payer: EPIC Health Plan Senior |
$32.18
|
| Rate for Payer: Galaxy Health WC |
$68.37
|
| Rate for Payer: Global Benefits Group Commercial |
$48.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.09
|
| Rate for Payer: Multiplan Commercial |
$60.33
|
| Rate for Payer: Networks By Design Commercial |
$40.22
|
| Rate for Payer: Prime Health Services Commercial |
$68.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$29.38
|
| Rate for Payer: United Healthcare HMO Rider |
$28.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.34
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
OP
|
$80.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$72.40 |
| Rate for Payer: Adventist Health Commercial |
$16.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.54
|
| Rate for Payer: Blue Shield of California Commercial |
$62.18
|
| Rate for Payer: Blue Shield of California EPN |
$40.54
|
| Rate for Payer: Cash Price |
$44.24
|
| Rate for Payer: Central Health Plan Commercial |
$64.35
|
| Rate for Payer: Cigna of CA HMO |
$56.31
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.18
|
| Rate for Payer: EPIC Health Plan Senior |
$32.18
|
| Rate for Payer: Galaxy Health WC |
$68.37
|
| Rate for Payer: Global Benefits Group Commercial |
$48.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.40
|
| Rate for Payer: InnovAge PACE Commercial |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.31
|
| Rate for Payer: Multiplan Commercial |
$60.33
|
| Rate for Payer: Networks By Design Commercial |
$40.22
|
| Rate for Payer: Prime Health Services Commercial |
$68.37
|
| Rate for Payer: Riverside University Health System MISP |
$32.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$29.38
|
| Rate for Payer: United Healthcare HMO Rider |
$28.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.37
|
| Rate for Payer: Vantage Medical Group Senior |
$68.37
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
OP
|
$54.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$48.85 |
| Rate for Payer: Adventist Health Commercial |
$10.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.05
|
| Rate for Payer: Blue Shield of California Commercial |
$41.96
|
| Rate for Payer: Blue Shield of California EPN |
$27.36
|
| Rate for Payer: Cash Price |
$29.85
|
| Rate for Payer: Central Health Plan Commercial |
$43.42
|
| Rate for Payer: Cigna of CA HMO |
$38.00
|
| Rate for Payer: Cigna of CA PPO |
$38.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$46.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.71
|
| Rate for Payer: EPIC Health Plan Senior |
$21.71
|
| Rate for Payer: Galaxy Health WC |
$46.14
|
| Rate for Payer: Global Benefits Group Commercial |
$32.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.85
|
| Rate for Payer: InnovAge PACE Commercial |
$27.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.00
|
| Rate for Payer: Multiplan Commercial |
$40.71
|
| Rate for Payer: Networks By Design Commercial |
$27.14
|
| Rate for Payer: Prime Health Services Commercial |
$46.14
|
| Rate for Payer: Riverside University Health System MISP |
$21.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.37
|
| Rate for Payer: United Healthcare All Other HMO |
$19.83
|
| Rate for Payer: United Healthcare HMO Rider |
$19.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.14
|
| Rate for Payer: Vantage Medical Group Senior |
$46.14
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
IP
|
$55.60
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$50.04 |
| Rate for Payer: Adventist Health Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California Commercial |
$42.98
|
| Rate for Payer: Blue Shield of California EPN |
$28.02
|
| Rate for Payer: Cash Price |
$30.58
|
| Rate for Payer: Central Health Plan Commercial |
$44.48
|
| Rate for Payer: Cigna of CA HMO |
$38.92
|
| Rate for Payer: Cigna of CA PPO |
$38.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.24
|
| Rate for Payer: EPIC Health Plan Senior |
$22.24
|
| Rate for Payer: Galaxy Health WC |
$47.26
|
| Rate for Payer: Global Benefits Group Commercial |
$33.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.12
|
| Rate for Payer: Multiplan Commercial |
$41.70
|
| Rate for Payer: Networks By Design Commercial |
$27.80
|
| Rate for Payer: Prime Health Services Commercial |
$47.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.87
|
| Rate for Payer: United Healthcare All Other HMO |
$20.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.21
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
OP
|
$55.60
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$50.04 |
| Rate for Payer: Adventist Health Commercial |
$11.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.79
|
| Rate for Payer: Blue Shield of California Commercial |
$42.98
|
| Rate for Payer: Blue Shield of California EPN |
$28.02
|
| Rate for Payer: Cash Price |
$30.58
|
| Rate for Payer: Central Health Plan Commercial |
$44.48
|
| Rate for Payer: Cigna of CA HMO |
$38.92
|
| Rate for Payer: Cigna of CA PPO |
$38.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.24
|
| Rate for Payer: EPIC Health Plan Senior |
$22.24
|
| Rate for Payer: Galaxy Health WC |
$47.26
|
| Rate for Payer: Global Benefits Group Commercial |
$33.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.04
|
| Rate for Payer: InnovAge PACE Commercial |
$27.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.92
|
| Rate for Payer: Multiplan Commercial |
$41.70
|
| Rate for Payer: Networks By Design Commercial |
$27.80
|
| Rate for Payer: Prime Health Services Commercial |
$47.26
|
| Rate for Payer: Riverside University Health System MISP |
$22.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.87
|
| Rate for Payer: United Healthcare All Other HMO |
$20.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.26
|
| Rate for Payer: Vantage Medical Group Senior |
$47.26
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
IP
|
$51.25
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$46.12 |
| Rate for Payer: Adventist Health Commercial |
$10.25
|
| Rate for Payer: Blue Shield of California Commercial |
$39.62
|
| Rate for Payer: Blue Shield of California EPN |
$25.83
|
| Rate for Payer: Cash Price |
$28.19
|
| Rate for Payer: Central Health Plan Commercial |
$41.00
|
| Rate for Payer: Cigna of CA HMO |
$35.88
|
| Rate for Payer: Cigna of CA PPO |
$35.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.50
|
| Rate for Payer: EPIC Health Plan Senior |
$20.50
|
| Rate for Payer: Galaxy Health WC |
$43.56
|
| Rate for Payer: Global Benefits Group Commercial |
$30.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Multiplan Commercial |
$38.44
|
| Rate for Payer: Networks By Design Commercial |
$25.62
|
| Rate for Payer: Prime Health Services Commercial |
$43.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.23
|
| Rate for Payer: United Healthcare All Other HMO |
$18.72
|
| Rate for Payer: United Healthcare HMO Rider |
$18.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.78
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
OP
|
$51.25
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$46.12 |
| Rate for Payer: Adventist Health Commercial |
$10.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.38
|
| Rate for Payer: Blue Shield of California Commercial |
$39.62
|
| Rate for Payer: Blue Shield of California EPN |
$25.83
|
| Rate for Payer: Cash Price |
$28.19
|
| Rate for Payer: Central Health Plan Commercial |
$41.00
|
| Rate for Payer: Cigna of CA HMO |
$35.88
|
| Rate for Payer: Cigna of CA PPO |
$35.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.50
|
| Rate for Payer: EPIC Health Plan Senior |
$20.50
|
| Rate for Payer: Galaxy Health WC |
$43.56
|
| Rate for Payer: Global Benefits Group Commercial |
$30.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.12
|
| Rate for Payer: InnovAge PACE Commercial |
$25.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.88
|
| Rate for Payer: Multiplan Commercial |
$38.44
|
| Rate for Payer: Networks By Design Commercial |
$25.62
|
| Rate for Payer: Prime Health Services Commercial |
$43.56
|
| Rate for Payer: Riverside University Health System MISP |
$20.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.23
|
| Rate for Payer: United Healthcare All Other HMO |
$18.72
|
| Rate for Payer: United Healthcare HMO Rider |
$18.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.56
|
| Rate for Payer: Vantage Medical Group Senior |
$43.56
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
OP
|
$58.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$52.40 |
| Rate for Payer: Adventist Health Commercial |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.24
|
| Rate for Payer: Blue Shield of California Commercial |
$45.00
|
| Rate for Payer: Blue Shield of California EPN |
$29.34
|
| Rate for Payer: Cash Price |
$32.02
|
| Rate for Payer: Central Health Plan Commercial |
$46.58
|
| Rate for Payer: Cigna of CA HMO |
$40.75
|
| Rate for Payer: Cigna of CA PPO |
$40.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Senior |
$23.29
|
| Rate for Payer: Galaxy Health WC |
$49.49
|
| Rate for Payer: Global Benefits Group Commercial |
$34.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.40
|
| Rate for Payer: InnovAge PACE Commercial |
$29.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40.75
|
| Rate for Payer: Multiplan Commercial |
$43.66
|
| Rate for Payer: Networks By Design Commercial |
$29.11
|
| Rate for Payer: Prime Health Services Commercial |
$49.49
|
| Rate for Payer: Riverside University Health System MISP |
$23.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.85
|
| Rate for Payer: United Healthcare All Other HMO |
$21.27
|
| Rate for Payer: United Healthcare HMO Rider |
$20.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.49
|
| Rate for Payer: Vantage Medical Group Senior |
$49.49
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
IP
|
$58.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$52.40 |
| Rate for Payer: Adventist Health Commercial |
$11.64
|
| Rate for Payer: Blue Shield of California Commercial |
$45.00
|
| Rate for Payer: Blue Shield of California EPN |
$29.34
|
| Rate for Payer: Cash Price |
$32.02
|
| Rate for Payer: Central Health Plan Commercial |
$46.58
|
| Rate for Payer: Cigna of CA HMO |
$40.75
|
| Rate for Payer: Cigna of CA PPO |
$40.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Senior |
$23.29
|
| Rate for Payer: Galaxy Health WC |
$49.49
|
| Rate for Payer: Global Benefits Group Commercial |
$34.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.64
|
| Rate for Payer: Multiplan Commercial |
$43.66
|
| Rate for Payer: Networks By Design Commercial |
$29.11
|
| Rate for Payer: Prime Health Services Commercial |
$49.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.85
|
| Rate for Payer: United Healthcare All Other HMO |
$21.27
|
| Rate for Payer: United Healthcare HMO Rider |
$20.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.07
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
IP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Blue Shield of California Commercial |
$43.54
|
| Rate for Payer: Blue Shield of California EPN |
$28.39
|
| Rate for Payer: Cash Price |
$30.98
|
| Rate for Payer: Central Health Plan Commercial |
$45.06
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$42.25
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
OP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.19
|
| Rate for Payer: Blue Shield of California Commercial |
$43.54
|
| Rate for Payer: Blue Shield of California EPN |
$28.39
|
| Rate for Payer: Cash Price |
$30.98
|
| Rate for Payer: Central Health Plan Commercial |
$45.06
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.70
|
| Rate for Payer: InnovAge PACE Commercial |
$28.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.43
|
| Rate for Payer: Multiplan Commercial |
$42.25
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: Riverside University Health System MISP |
$22.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.88
|
| Rate for Payer: Vantage Medical Group Senior |
$47.88
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
IP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$53.28 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Blue Shield of California Commercial |
$45.76
|
| Rate for Payer: Blue Shield of California EPN |
$29.84
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Central Health Plan Commercial |
$47.36
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.84
|
| Rate for Payer: Multiplan Commercial |
$44.40
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
OP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$53.28 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.78
|
| Rate for Payer: Blue Shield of California Commercial |
$45.76
|
| Rate for Payer: Blue Shield of California EPN |
$29.84
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Central Health Plan Commercial |
$47.36
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.28
|
| Rate for Payer: InnovAge PACE Commercial |
$29.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.44
|
| Rate for Payer: Multiplan Commercial |
$44.40
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: Riverside University Health System MISP |
$23.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.32
|
| Rate for Payer: Vantage Medical Group Senior |
$50.32
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
OP
|
$1,206.72
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.34 |
| Max. Negotiated Rate |
$1,086.05 |
| Rate for Payer: Adventist Health Commercial |
$241.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$663.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$905.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$668.16
|
| Rate for Payer: Blue Shield of California Commercial |
$932.79
|
| Rate for Payer: Blue Shield of California EPN |
$608.19
|
| Rate for Payer: Cash Price |
$663.70
|
| Rate for Payer: Central Health Plan Commercial |
$965.38
|
| Rate for Payer: Cigna of CA HMO |
$844.70
|
| Rate for Payer: Cigna of CA PPO |
$844.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,025.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,025.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.69
|
| Rate for Payer: EPIC Health Plan Senior |
$482.69
|
| Rate for Payer: Galaxy Health WC |
$1,025.71
|
| Rate for Payer: Global Benefits Group Commercial |
$724.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,086.05
|
| Rate for Payer: InnovAge PACE Commercial |
$603.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$804.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$746.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$844.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$844.70
|
| Rate for Payer: Multiplan Commercial |
$905.04
|
| Rate for Payer: Networks By Design Commercial |
$603.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,025.71
|
| Rate for Payer: Riverside University Health System MISP |
$482.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$724.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$724.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.88
|
| Rate for Payer: United Healthcare All Other HMO |
$440.81
|
| Rate for Payer: United Healthcare HMO Rider |
$431.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,025.71
|
| Rate for Payer: Vantage Medical Group Senior |
$1,025.71
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
IP
|
$1,206.72
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.34 |
| Max. Negotiated Rate |
$1,086.05 |
| Rate for Payer: Adventist Health Commercial |
$241.34
|
| Rate for Payer: Blue Shield of California Commercial |
$932.79
|
| Rate for Payer: Blue Shield of California EPN |
$608.19
|
| Rate for Payer: Cash Price |
$663.70
|
| Rate for Payer: Central Health Plan Commercial |
$965.38
|
| Rate for Payer: Cigna of CA HMO |
$844.70
|
| Rate for Payer: Cigna of CA PPO |
$844.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.69
|
| Rate for Payer: EPIC Health Plan Senior |
$482.69
|
| Rate for Payer: Galaxy Health WC |
$1,025.71
|
| Rate for Payer: Global Benefits Group Commercial |
$724.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,086.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$804.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$746.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.34
|
| Rate for Payer: Multiplan Commercial |
$905.04
|
| Rate for Payer: Networks By Design Commercial |
$603.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,025.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.88
|
| Rate for Payer: United Healthcare All Other HMO |
$440.81
|
| Rate for Payer: United Healthcare HMO Rider |
$431.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.20
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
IP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Cash Price |
$349.14
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
OP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$385.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$307.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$372.82
|
| Rate for Payer: Blue Shield of California Commercial |
$387.86
|
| Rate for Payer: Blue Shield of California EPN |
$253.29
|
| Rate for Payer: Cash Price |
$349.14
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$539.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: InnovAge PACE Commercial |
$317.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$444.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$444.36
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Riverside University Health System MISP |
$253.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Blue Shield of California Commercial |
$575.11
|
| Rate for Payer: Blue Shield of California EPN |
$374.98
|
| Rate for Payer: Cash Price |
$409.20
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$460.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$339.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$411.95
|
| Rate for Payer: Blue Shield of California Commercial |
$575.11
|
| Rate for Payer: Blue Shield of California EPN |
$374.98
|
| Rate for Payer: Cash Price |
$409.20
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$632.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: InnovAge PACE Commercial |
$372.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$460.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$520.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Riverside University Health System MISP |
$297.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.40
|
| Rate for Payer: Vantage Medical Group Senior |
$632.40
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,159.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
IP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Cash Price |
$92.94
|
| Rate for Payer: Central Health Plan Commercial |
$135.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Multiplan Commercial |
$126.73
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
OP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$102.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$92.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$126.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$81.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.24
|
| Rate for Payer: Blue Shield of California Commercial |
$103.25
|
| Rate for Payer: Blue Shield of California EPN |
$67.42
|
| Rate for Payer: Cash Price |
$92.94
|
| Rate for Payer: Central Health Plan Commercial |
$135.18
|
| Rate for Payer: Cigna of CA HMO |
$108.15
|
| Rate for Payer: Cigna of CA PPO |
$125.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$143.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$143.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.08
|
| Rate for Payer: InnovAge PACE Commercial |
$84.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$118.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$118.29
|
| Rate for Payer: Multiplan Commercial |
$126.73
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
| Rate for Payer: Riverside University Health System MISP |
$67.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.49
|
| Rate for Payer: United Healthcare All Other HMO |
$84.49
|
| Rate for Payer: United Healthcare HMO Rider |
$84.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.63
|
| Rate for Payer: Vantage Medical Group Senior |
$143.63
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
OP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$774.18 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$522.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$645.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$416.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$505.20
|
| Rate for Payer: Blue Shield of California Commercial |
$525.58
|
| Rate for Payer: Blue Shield of California EPN |
$343.22
|
| Rate for Payer: Cash Price |
$473.11
|
| Rate for Payer: Central Health Plan Commercial |
$688.16
|
| Rate for Payer: Cigna of CA HMO |
$550.53
|
| Rate for Payer: Cigna of CA PPO |
$636.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$731.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.18
|
| Rate for Payer: InnovAge PACE Commercial |
$430.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$532.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.14
|
| Rate for Payer: Multiplan Commercial |
$645.15
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
| Rate for Payer: Riverside University Health System MISP |
$344.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$430.10
|
| Rate for Payer: United Healthcare All Other HMO |
$430.10
|
| Rate for Payer: United Healthcare HMO Rider |
$430.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$430.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Vantage Medical Group Senior |
$731.17
|
|
