|
HC CATH VASC PRONTO LP
|
Facility
|
OP
|
$1,978.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.60 |
| Max. Negotiated Rate |
$1,780.20 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,201.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,087.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,483.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$957.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,161.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,208.56
|
| Rate for Payer: Blue Shield of California EPN |
$789.22
|
| Rate for Payer: Cash Price |
$1,087.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,582.40
|
| Rate for Payer: Cigna of CA HMO |
$1,265.92
|
| Rate for Payer: Cigna of CA PPO |
$1,463.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,681.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,681.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Senior |
$791.20
|
| Rate for Payer: Galaxy Health WC |
$1,681.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,186.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,780.20
|
| Rate for Payer: InnovAge PACE Commercial |
$989.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,319.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$753.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,224.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,384.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,384.60
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
| Rate for Payer: Networks By Design Commercial |
$1,285.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,681.30
|
| Rate for Payer: Riverside University Health System MISP |
$791.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,186.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,186.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.00
|
| Rate for Payer: United Healthcare All Other HMO |
$989.00
|
| Rate for Payer: United Healthcare HMO Rider |
$989.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$989.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,681.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,681.30
|
|
|
HC CATH VASC PRONTO LP
|
Facility
|
IP
|
$1,978.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.60 |
| Max. Negotiated Rate |
$1,780.20 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Cash Price |
$1,087.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,582.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Senior |
$791.20
|
| Rate for Payer: Galaxy Health WC |
$1,681.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,186.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,780.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,319.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$753.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,224.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.60
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
| Rate for Payer: Networks By Design Commercial |
$1,285.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,681.30
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$488.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$389.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$472.78
|
| Rate for Payer: Blue Shield of California Commercial |
$491.86
|
| Rate for Payer: Blue Shield of California EPN |
$321.19
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: InnovAge PACE Commercial |
$402.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$402.50
|
| Rate for Payer: United Healthcare All Other HMO |
$402.50
|
| Rate for Payer: United Healthcare HMO Rider |
$402.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$402.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH VASC SWITH IT
|
Facility
|
OP
|
$621.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.20 |
| Max. Negotiated Rate |
$558.90 |
| Rate for Payer: Adventist Health Commercial |
$124.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$377.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$527.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$341.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$300.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.71
|
| Rate for Payer: Blue Shield of California Commercial |
$379.43
|
| Rate for Payer: Blue Shield of California EPN |
$247.78
|
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Central Health Plan Commercial |
$496.80
|
| Rate for Payer: Cigna of CA HMO |
$397.44
|
| Rate for Payer: Cigna of CA PPO |
$459.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$527.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$527.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$248.40
|
| Rate for Payer: EPIC Health Plan Senior |
$248.40
|
| Rate for Payer: Galaxy Health WC |
$527.85
|
| Rate for Payer: Global Benefits Group Commercial |
$372.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$558.90
|
| Rate for Payer: InnovAge PACE Commercial |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$414.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$384.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$434.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$434.70
|
| Rate for Payer: Multiplan Commercial |
$465.75
|
| Rate for Payer: Networks By Design Commercial |
$403.65
|
| Rate for Payer: Prime Health Services Commercial |
$527.85
|
| Rate for Payer: Riverside University Health System MISP |
$248.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$372.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$372.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.50
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$310.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$527.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.85
|
| Rate for Payer: Vantage Medical Group Senior |
$527.85
|
|
|
HC CATH VASC SWITH IT
|
Facility
|
IP
|
$621.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.20 |
| Max. Negotiated Rate |
$558.90 |
| Rate for Payer: Adventist Health Commercial |
$124.20
|
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Central Health Plan Commercial |
$496.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$248.40
|
| Rate for Payer: EPIC Health Plan Senior |
$248.40
|
| Rate for Payer: Galaxy Health WC |
$527.85
|
| Rate for Payer: Global Benefits Group Commercial |
$372.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$558.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$414.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$384.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.20
|
| Rate for Payer: Multiplan Commercial |
$465.75
|
| Rate for Payer: Networks By Design Commercial |
$403.65
|
| Rate for Payer: Prime Health Services Commercial |
$527.85
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
OP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$907.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$822.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,121.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$723.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$878.01
|
| Rate for Payer: Blue Shield of California Commercial |
$913.45
|
| Rate for Payer: Blue Shield of California EPN |
$596.50
|
| Rate for Payer: Cash Price |
$822.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Cigna of CA HMO |
$956.80
|
| Rate for Payer: Cigna of CA PPO |
$1,106.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,270.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,270.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: InnovAge PACE Commercial |
$747.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,046.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,046.50
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
| Rate for Payer: Riverside University Health System MISP |
$598.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$747.50
|
| Rate for Payer: United Healthcare All Other HMO |
$747.50
|
| Rate for Payer: United Healthcare HMO Rider |
$747.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$747.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,270.75
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
IP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Cash Price |
$822.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,350.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,405.30
|
| Rate for Payer: Blue Shield of California EPN |
$917.70
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
IP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Cash Price |
$451.70
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$508.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
OP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$451.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$615.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$482.34
|
| Rate for Payer: Blue Shield of California Commercial |
$501.80
|
| Rate for Payer: Blue Shield of California EPN |
$327.69
|
| Rate for Payer: Cash Price |
$451.70
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: Cigna of CA HMO |
$525.62
|
| Rate for Payer: Cigna of CA PPO |
$607.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: InnovAge PACE Commercial |
$410.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$508.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$574.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$574.90
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
| Rate for Payer: Riverside University Health System MISP |
$328.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$492.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$492.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$410.64
|
| Rate for Payer: United Healthcare All Other HMO |
$410.64
|
| Rate for Payer: United Healthcare HMO Rider |
$410.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$410.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.09
|
| Rate for Payer: Vantage Medical Group Senior |
$698.09
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,350.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,405.30
|
| Rate for Payer: Blue Shield of California EPN |
$917.70
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VIRDEN
|
Facility
|
IP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$199.58 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Cash Price |
$121.97
|
| Rate for Payer: Central Health Plan Commercial |
$177.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.35
|
| Rate for Payer: Multiplan Commercial |
$166.32
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
|
|
HC CATH VIRDEN
|
Facility
|
OP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$199.58 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$166.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.24
|
| Rate for Payer: Blue Shield of California Commercial |
$135.50
|
| Rate for Payer: Blue Shield of California EPN |
$88.48
|
| Rate for Payer: Cash Price |
$121.97
|
| Rate for Payer: Central Health Plan Commercial |
$177.41
|
| Rate for Payer: Cigna of CA HMO |
$141.93
|
| Rate for Payer: Cigna of CA PPO |
$164.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$188.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.58
|
| Rate for Payer: InnovAge PACE Commercial |
$110.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$155.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$155.23
|
| Rate for Payer: Multiplan Commercial |
$166.32
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
| Rate for Payer: Riverside University Health System MISP |
$88.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.88
|
| Rate for Payer: United Healthcare All Other HMO |
$110.88
|
| Rate for Payer: United Healthcare HMO Rider |
$110.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.50
|
| Rate for Payer: Vantage Medical Group Senior |
$188.50
|
|
|
HC CATH VLCNO MICROCATH
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH VLCNO MICROCATH
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,050.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,273.51
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VLCNO REVOLUTION IVUS
|
Facility
|
OP
|
$2,633.00
|
|
| Hospital Charge Code |
906812376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.60 |
| Max. Negotiated Rate |
$2,369.70 |
| Rate for Payer: Adventist Health Commercial |
$526.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,448.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,974.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,202.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,457.89
|
| Rate for Payer: Blue Shield of California Commercial |
$2,035.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,327.03
|
| Rate for Payer: Cash Price |
$1,448.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,106.40
|
| Rate for Payer: Cigna of CA HMO |
$1,843.10
|
| Rate for Payer: Cigna of CA PPO |
$1,843.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,238.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,238.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,053.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,053.20
|
| Rate for Payer: Galaxy Health WC |
$2,238.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,579.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,369.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,316.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,756.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,629.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,843.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,843.10
|
| Rate for Payer: Multiplan Commercial |
$1,974.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,238.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,053.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,579.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,579.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$988.16
|
| Rate for Payer: United Healthcare All Other HMO |
$961.83
|
| Rate for Payer: United Healthcare HMO Rider |
$941.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,238.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,238.05
|
|
|
HC CATH VLCNO REVOLUTION IVUS
|
Facility
|
IP
|
$2,633.00
|
|
| Hospital Charge Code |
906812376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.60 |
| Max. Negotiated Rate |
$2,369.70 |
| Rate for Payer: Adventist Health Commercial |
$526.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,035.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,327.03
|
| Rate for Payer: Cash Price |
$1,448.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,106.40
|
| Rate for Payer: Cigna of CA HMO |
$1,843.10
|
| Rate for Payer: Cigna of CA PPO |
$1,843.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,053.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,053.20
|
| Rate for Payer: Galaxy Health WC |
$2,238.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,579.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,369.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,756.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,629.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$526.60
|
| Rate for Payer: Multiplan Commercial |
$1,974.75
|
| Rate for Payer: Networks By Design Commercial |
$1,316.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,238.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$988.16
|
| Rate for Payer: United Healthcare All Other HMO |
$961.83
|
| Rate for Payer: United Healthcare HMO Rider |
$941.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.31
|
|
|
HC CATH VLCNO VISIONS PV IV US
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
906812508
|
|
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 VLCNO VISIONS PV IV US
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
906812508
|
|
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 WHISTLE TIP 10-12FR
|
Facility
|
OP
|
$11.73
|
|
| Hospital Charge Code |
901601347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.89
|
| Rate for Payer: Blue Shield of California Commercial |
$7.17
|
| Rate for Payer: Blue Shield of California EPN |
$4.68
|
| Rate for Payer: Cash Price |
$6.45
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Cigna of CA HMO |
$7.51
|
| Rate for Payer: Cigna of CA PPO |
$8.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: InnovAge PACE Commercial |
$5.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.21
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
| Rate for Payer: Riverside University Health System MISP |
$4.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.87
|
| Rate for Payer: United Healthcare All Other HMO |
$5.87
|
| Rate for Payer: United Healthcare HMO Rider |
$5.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9.97
|
|
|
HC CATH WHISTLE TIP 10-12FR
|
Facility
|
IP
|
$11.73
|
|
| Hospital Charge Code |
901601347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Cash Price |
$6.45
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
|
HC CATH WHISTLE TIP 14-16FR
|
Facility
|
IP
|
$11.73
|
|
| Hospital Charge Code |
901601348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Cash Price |
$6.45
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Senior |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
