|
HC CNTRL NASAL HEM POSTERIOR
|
Facility
|
OP
|
$1,060.00
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
900501116
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$434.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Central Health Plan Commercial |
$848.00
|
| Rate for Payer: Cigna of CA HMO |
$678.40
|
| Rate for Payer: Cigna of CA PPO |
$784.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$901.00
|
| Rate for Payer: Global Benefits Group Commercial |
$636.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$954.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$707.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$795.00
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$689.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$901.00
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$636.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$636.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC CNTRL NASAL HEM POSTERIOR
|
Facility
|
OP
|
$1,060.00
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
900501116
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$212.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Central Health Plan Commercial |
$848.00
|
| Rate for Payer: Cigna of CA HMO |
$678.40
|
| Rate for Payer: Cigna of CA PPO |
$784.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$901.00
|
| Rate for Payer: Global Benefits Group Commercial |
$636.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$954.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$707.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$795.00
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$689.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$901.00
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$636.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$530.00
|
| Rate for Payer: United Healthcare All Other HMO |
$530.00
|
| Rate for Payer: United Healthcare HMO Rider |
$530.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC CNTRL NASAL HEM POSTERIOR
|
Facility
|
IP
|
$1,060.00
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
900501116
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$954.00 |
| Rate for Payer: Adventist Health Commercial |
$212.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Central Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.00
|
| Rate for Payer: EPIC Health Plan Senior |
$424.00
|
| Rate for Payer: Galaxy Health WC |
$901.00
|
| Rate for Payer: Global Benefits Group Commercial |
$636.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$954.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$707.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$656.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.00
|
| Rate for Payer: Multiplan Commercial |
$795.00
|
| Rate for Payer: Networks By Design Commercial |
$689.00
|
| Rate for Payer: Prime Health Services Commercial |
$901.00
|
|
|
HC CNTRL NASAL HEM POSTERIOR
|
Facility
|
IP
|
$1,060.00
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
900501116
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$954.00 |
| Rate for Payer: Adventist Health Commercial |
$212.00
|
| Rate for Payer: Cash Price |
$583.00
|
| Rate for Payer: Central Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.00
|
| Rate for Payer: EPIC Health Plan Senior |
$424.00
|
| Rate for Payer: Galaxy Health WC |
$901.00
|
| Rate for Payer: Global Benefits Group Commercial |
$636.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$954.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$707.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$656.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.00
|
| Rate for Payer: Multiplan Commercial |
$795.00
|
| Rate for Payer: Networks By Design Commercial |
$689.00
|
| Rate for Payer: Prime Health Services Commercial |
$901.00
|
|
|
HC CNTRL NASAL HEM POST SUBSQ
|
Facility
|
OP
|
$807.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
900501117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$330.87
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Central Health Plan Commercial |
$645.60
|
| Rate for Payer: Cigna of CA HMO |
$516.48
|
| Rate for Payer: Cigna of CA PPO |
$597.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$726.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$666.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$605.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$524.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$685.95
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$484.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$484.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC CNTRL NASAL HEM POST SUBSQ
|
Facility
|
IP
|
$807.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
900501117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$726.30 |
| Rate for Payer: Adventist Health Commercial |
$161.40
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Central Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.80
|
| Rate for Payer: EPIC Health Plan Senior |
$322.80
|
| Rate for Payer: Galaxy Health WC |
$685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$726.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$499.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.40
|
| Rate for Payer: Multiplan Commercial |
$605.25
|
| Rate for Payer: Networks By Design Commercial |
$524.55
|
| Rate for Payer: Prime Health Services Commercial |
$685.95
|
|
|
HC CNTRL NASAL HEM POST SUBSQ
|
Facility
|
OP
|
$807.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
900501117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$161.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Central Health Plan Commercial |
$645.60
|
| Rate for Payer: Cigna of CA HMO |
$516.48
|
| Rate for Payer: Cigna of CA PPO |
$597.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$726.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$666.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$605.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$524.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$685.95
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$484.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$403.50
|
| Rate for Payer: United Healthcare All Other HMO |
$403.50
|
| Rate for Payer: United Healthcare HMO Rider |
$403.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$403.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC CNTRL NASAL HEM POST SUBSQ
|
Facility
|
IP
|
$807.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
900501117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$726.30 |
| Rate for Payer: Adventist Health Commercial |
$161.40
|
| Rate for Payer: Cash Price |
$443.85
|
| Rate for Payer: Central Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.80
|
| Rate for Payer: EPIC Health Plan Senior |
$322.80
|
| Rate for Payer: Galaxy Health WC |
$685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$726.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$499.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.40
|
| Rate for Payer: Multiplan Commercial |
$605.25
|
| Rate for Payer: Networks By Design Commercial |
$524.55
|
| Rate for Payer: Prime Health Services Commercial |
$685.95
|
|
|
HC CNTRL ORO HEM W SURG INTRV
|
Facility
|
OP
|
$10,844.00
|
|
|
Service Code
|
CPT 42962
|
| Hospital Charge Code |
900542962
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,759.60 |
| Rate for Payer: Adventist Health Commercial |
$2,168.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$5,964.20
|
| Rate for Payer: Cash Price |
$5,964.20
|
| Rate for Payer: Cash Price |
$5,964.20
|
| Rate for Payer: Cash Price |
$5,964.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,675.20
|
| Rate for Payer: Cigna of CA HMO |
$6,940.16
|
| Rate for Payer: Cigna of CA PPO |
$8,024.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$9,217.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,506.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,759.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,232.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$783.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,168.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$8,133.00
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$7,048.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,217.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,506.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,422.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,422.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,422.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,422.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC CNTRL ORO HEM W SURG INTRV
|
Facility
|
IP
|
$10,844.00
|
|
|
Service Code
|
CPT 42962
|
| Hospital Charge Code |
900542962
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,168.80 |
| Max. Negotiated Rate |
$9,759.60 |
| Rate for Payer: Adventist Health Commercial |
$2,168.80
|
| Rate for Payer: Cash Price |
$5,964.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,675.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,337.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,337.60
|
| Rate for Payer: Galaxy Health WC |
$9,217.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,506.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,759.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,232.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,131.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,712.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,168.80
|
| Rate for Payer: Multiplan Commercial |
$8,133.00
|
| Rate for Payer: Networks By Design Commercial |
$7,048.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,217.40
|
|
|
HC CNTRL VNS CATH KIT 2LUMEN 9FR
|
Facility
|
IP
|
$755.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.19 |
| Max. Negotiated Rate |
$680.36 |
| Rate for Payer: Adventist Health Commercial |
$151.19
|
| Rate for Payer: Blue Shield of California Commercial |
$584.36
|
| Rate for Payer: Blue Shield of California EPN |
$381.00
|
| Rate for Payer: Cash Price |
$415.78
|
| Rate for Payer: Central Health Plan Commercial |
$604.77
|
| Rate for Payer: Cigna of CA HMO |
$529.17
|
| Rate for Payer: Cigna of CA PPO |
$529.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$302.38
|
| Rate for Payer: EPIC Health Plan Senior |
$302.38
|
| Rate for Payer: Galaxy Health WC |
$642.57
|
| Rate for Payer: Global Benefits Group Commercial |
$453.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$680.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$504.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$467.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.19
|
| Rate for Payer: Multiplan Commercial |
$566.97
|
| Rate for Payer: Networks By Design Commercial |
$377.98
|
| Rate for Payer: Prime Health Services Commercial |
$642.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$283.71
|
| Rate for Payer: United Healthcare All Other HMO |
$276.15
|
| Rate for Payer: United Healthcare HMO Rider |
$270.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$247.58
|
|
|
HC CNTRL VNS CATH KIT 2LUMEN 9FR
|
Facility
|
OP
|
$755.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.19 |
| Max. Negotiated Rate |
$680.36 |
| Rate for Payer: Adventist Health Commercial |
$151.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$642.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$415.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$566.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$345.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$418.58
|
| Rate for Payer: Blue Shield of California Commercial |
$584.36
|
| Rate for Payer: Blue Shield of California EPN |
$381.00
|
| Rate for Payer: Cash Price |
$415.78
|
| Rate for Payer: Central Health Plan Commercial |
$604.77
|
| Rate for Payer: Cigna of CA HMO |
$529.17
|
| Rate for Payer: Cigna of CA PPO |
$529.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$642.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$642.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$642.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$302.38
|
| Rate for Payer: EPIC Health Plan Senior |
$302.38
|
| Rate for Payer: Galaxy Health WC |
$642.57
|
| Rate for Payer: Global Benefits Group Commercial |
$453.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$680.36
|
| Rate for Payer: InnovAge PACE Commercial |
$377.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$504.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$467.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$529.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.17
|
| Rate for Payer: Multiplan Commercial |
$566.97
|
| Rate for Payer: Networks By Design Commercial |
$377.98
|
| Rate for Payer: Prime Health Services Commercial |
$642.57
|
| Rate for Payer: Riverside University Health System MISP |
$302.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$453.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$453.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$283.71
|
| Rate for Payer: United Healthcare All Other HMO |
$276.15
|
| Rate for Payer: United Healthcare HMO Rider |
$270.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$247.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$642.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$642.57
|
| Rate for Payer: Vantage Medical Group Senior |
$642.57
|
|
|
HC CNTRL VNS CATH KIT 4FR DL
|
Facility
|
OP
|
$598.87
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.77 |
| Max. Negotiated Rate |
$538.98 |
| Rate for Payer: Adventist Health Commercial |
$119.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$509.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$329.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$273.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$331.59
|
| Rate for Payer: Blue Shield of California Commercial |
$462.93
|
| Rate for Payer: Blue Shield of California EPN |
$301.83
|
| Rate for Payer: Cash Price |
$329.38
|
| Rate for Payer: Central Health Plan Commercial |
$479.10
|
| Rate for Payer: Cigna of CA HMO |
$419.21
|
| Rate for Payer: Cigna of CA PPO |
$419.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$509.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$509.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$509.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.55
|
| Rate for Payer: EPIC Health Plan Senior |
$239.55
|
| Rate for Payer: Galaxy Health WC |
$509.04
|
| Rate for Payer: Global Benefits Group Commercial |
$359.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.98
|
| Rate for Payer: InnovAge PACE Commercial |
$299.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$399.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$419.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$419.21
|
| Rate for Payer: Multiplan Commercial |
$449.15
|
| Rate for Payer: Networks By Design Commercial |
$299.44
|
| Rate for Payer: Prime Health Services Commercial |
$509.04
|
| Rate for Payer: Riverside University Health System MISP |
$239.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$359.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$359.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.76
|
| Rate for Payer: United Healthcare All Other HMO |
$218.77
|
| Rate for Payer: United Healthcare HMO Rider |
$214.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$509.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$509.04
|
| Rate for Payer: Vantage Medical Group Senior |
$509.04
|
|
|
HC CNTRL VNS CATH KIT 4FR DL
|
Facility
|
IP
|
$598.87
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.77 |
| Max. Negotiated Rate |
$538.98 |
| Rate for Payer: Adventist Health Commercial |
$119.77
|
| Rate for Payer: Blue Shield of California Commercial |
$462.93
|
| Rate for Payer: Blue Shield of California EPN |
$301.83
|
| Rate for Payer: Cash Price |
$329.38
|
| Rate for Payer: Central Health Plan Commercial |
$479.10
|
| Rate for Payer: Cigna of CA HMO |
$419.21
|
| Rate for Payer: Cigna of CA PPO |
$419.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.55
|
| Rate for Payer: EPIC Health Plan Senior |
$239.55
|
| Rate for Payer: Galaxy Health WC |
$509.04
|
| Rate for Payer: Global Benefits Group Commercial |
$359.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$399.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.77
|
| Rate for Payer: Multiplan Commercial |
$449.15
|
| Rate for Payer: Networks By Design Commercial |
$299.44
|
| Rate for Payer: Prime Health Services Commercial |
$509.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.76
|
| Rate for Payer: United Healthcare All Other HMO |
$218.77
|
| Rate for Payer: United Healthcare HMO Rider |
$214.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.13
|
|
|
HC CNTRL VNS CATH KIT DL 4FR
|
Facility
|
OP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698610
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$316.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$192.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.79
|
| Rate for Payer: Blue Shield of California Commercial |
$326.39
|
| Rate for Payer: Blue Shield of California EPN |
$212.81
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$358.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$358.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: InnovAge PACE Commercial |
$211.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$295.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$295.57
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: Riverside University Health System MISP |
$168.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.90
|
| Rate for Payer: Vantage Medical Group Senior |
$358.90
|
|
|
HC CNTRL VNS CATH KIT DL 4FR
|
Facility
|
IP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698610
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Blue Shield of California Commercial |
$326.39
|
| Rate for Payer: Blue Shield of California EPN |
$212.81
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
|
|
HC CNTRL VNS CATH KIT DL 8FR 16CM
|
Facility
|
IP
|
$678.45
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698539
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.69 |
| Max. Negotiated Rate |
$610.61 |
| Rate for Payer: Adventist Health Commercial |
$135.69
|
| Rate for Payer: Cash Price |
$373.15
|
| Rate for Payer: Central Health Plan Commercial |
$542.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$271.38
|
| Rate for Payer: EPIC Health Plan Senior |
$271.38
|
| Rate for Payer: Galaxy Health WC |
$576.68
|
| Rate for Payer: Global Benefits Group Commercial |
$407.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$610.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$452.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$419.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.69
|
| Rate for Payer: Multiplan Commercial |
$508.84
|
| Rate for Payer: Networks By Design Commercial |
$440.99
|
| Rate for Payer: Prime Health Services Commercial |
$576.68
|
|
|
HC CNTRL VNS CATH KIT DL 8FR 16CM
|
Facility
|
OP
|
$678.45
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698539
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.69 |
| Max. Negotiated Rate |
$610.61 |
| Rate for Payer: Adventist Health Commercial |
$135.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$412.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$576.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$373.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$508.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$328.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$398.45
|
| Rate for Payer: Blue Shield of California Commercial |
$414.53
|
| Rate for Payer: Blue Shield of California EPN |
$270.70
|
| Rate for Payer: Cash Price |
$373.15
|
| Rate for Payer: Central Health Plan Commercial |
$542.76
|
| Rate for Payer: Cigna of CA HMO |
$434.21
|
| Rate for Payer: Cigna of CA PPO |
$502.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$576.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$576.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$576.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$271.38
|
| Rate for Payer: EPIC Health Plan Senior |
$271.38
|
| Rate for Payer: Galaxy Health WC |
$576.68
|
| Rate for Payer: Global Benefits Group Commercial |
$407.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$610.61
|
| Rate for Payer: InnovAge PACE Commercial |
$339.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$452.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$419.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$474.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$474.92
|
| Rate for Payer: Multiplan Commercial |
$508.84
|
| Rate for Payer: Networks By Design Commercial |
$440.99
|
| Rate for Payer: Prime Health Services Commercial |
$576.68
|
| Rate for Payer: Riverside University Health System MISP |
$271.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$407.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$407.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$339.23
|
| Rate for Payer: United Healthcare All Other HMO |
$339.23
|
| Rate for Payer: United Healthcare HMO Rider |
$339.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$339.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$576.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$576.68
|
| Rate for Payer: Vantage Medical Group Senior |
$576.68
|
|
|
HC CNTRL VNS CATH KIT MAC DL 9FR
|
Facility
|
OP
|
$879.38
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$791.44 |
| Rate for Payer: Adventist Health Commercial |
$175.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$659.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$401.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$486.91
|
| Rate for Payer: Blue Shield of California Commercial |
$679.76
|
| Rate for Payer: Blue Shield of California EPN |
$443.21
|
| Rate for Payer: Cash Price |
$483.66
|
| Rate for Payer: Central Health Plan Commercial |
$703.50
|
| Rate for Payer: Cigna of CA HMO |
$615.57
|
| Rate for Payer: Cigna of CA PPO |
$615.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$747.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$747.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.75
|
| Rate for Payer: EPIC Health Plan Senior |
$351.75
|
| Rate for Payer: Galaxy Health WC |
$747.47
|
| Rate for Payer: Global Benefits Group Commercial |
$527.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$791.44
|
| Rate for Payer: InnovAge PACE Commercial |
$439.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$544.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$615.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$615.57
|
| Rate for Payer: Multiplan Commercial |
$659.53
|
| Rate for Payer: Networks By Design Commercial |
$439.69
|
| Rate for Payer: Prime Health Services Commercial |
$747.47
|
| Rate for Payer: Riverside University Health System MISP |
$351.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$330.03
|
| Rate for Payer: United Healthcare All Other HMO |
$321.24
|
| Rate for Payer: United Healthcare HMO Rider |
$314.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$747.47
|
| Rate for Payer: Vantage Medical Group Senior |
$747.47
|
|
|
HC CNTRL VNS CATH KIT MAC DL 9FR
|
Facility
|
IP
|
$879.38
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.88 |
| Max. Negotiated Rate |
$791.44 |
| Rate for Payer: Adventist Health Commercial |
$175.88
|
| Rate for Payer: Blue Shield of California Commercial |
$679.76
|
| Rate for Payer: Blue Shield of California EPN |
$443.21
|
| Rate for Payer: Cash Price |
$483.66
|
| Rate for Payer: Central Health Plan Commercial |
$703.50
|
| Rate for Payer: Cigna of CA HMO |
$615.57
|
| Rate for Payer: Cigna of CA PPO |
$615.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.75
|
| Rate for Payer: EPIC Health Plan Senior |
$351.75
|
| Rate for Payer: Galaxy Health WC |
$747.47
|
| Rate for Payer: Global Benefits Group Commercial |
$527.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$791.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$544.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.88
|
| Rate for Payer: Multiplan Commercial |
$659.53
|
| Rate for Payer: Networks By Design Commercial |
$439.69
|
| Rate for Payer: Prime Health Services Commercial |
$747.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$330.03
|
| Rate for Payer: United Healthcare All Other HMO |
$321.24
|
| Rate for Payer: United Healthcare HMO Rider |
$314.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.00
|
|
|
HC CNTRL VNS CATH KIT QL 8.5FR
|
Facility
|
IP
|
$791.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.21 |
| Max. Negotiated Rate |
$711.95 |
| Rate for Payer: Adventist Health Commercial |
$158.21
|
| Rate for Payer: Blue Shield of California Commercial |
$611.49
|
| Rate for Payer: Blue Shield of California EPN |
$398.69
|
| Rate for Payer: Cash Price |
$435.08
|
| Rate for Payer: Central Health Plan Commercial |
$632.85
|
| Rate for Payer: Cigna of CA HMO |
$553.74
|
| Rate for Payer: Cigna of CA PPO |
$553.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.42
|
| Rate for Payer: EPIC Health Plan Senior |
$316.42
|
| Rate for Payer: Galaxy Health WC |
$672.40
|
| Rate for Payer: Global Benefits Group Commercial |
$474.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.21
|
| Rate for Payer: Multiplan Commercial |
$593.29
|
| Rate for Payer: Networks By Design Commercial |
$395.53
|
| Rate for Payer: Prime Health Services Commercial |
$672.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.88
|
| Rate for Payer: United Healthcare All Other HMO |
$288.97
|
| Rate for Payer: United Healthcare HMO Rider |
$282.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.07
|
|
|
HC CNTRL VNS CATH KIT QL 8.5FR
|
Facility
|
OP
|
$791.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.21 |
| Max. Negotiated Rate |
$711.95 |
| Rate for Payer: Adventist Health Commercial |
$158.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$361.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.01
|
| Rate for Payer: Blue Shield of California Commercial |
$611.49
|
| Rate for Payer: Blue Shield of California EPN |
$398.69
|
| Rate for Payer: Cash Price |
$435.08
|
| Rate for Payer: Central Health Plan Commercial |
$632.85
|
| Rate for Payer: Cigna of CA HMO |
$553.74
|
| Rate for Payer: Cigna of CA PPO |
$553.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.42
|
| Rate for Payer: EPIC Health Plan Senior |
$316.42
|
| Rate for Payer: Galaxy Health WC |
$672.40
|
| Rate for Payer: Global Benefits Group Commercial |
$474.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.95
|
| Rate for Payer: InnovAge PACE Commercial |
$395.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$553.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$553.74
|
| Rate for Payer: Multiplan Commercial |
$593.29
|
| Rate for Payer: Networks By Design Commercial |
$395.53
|
| Rate for Payer: Prime Health Services Commercial |
$672.40
|
| Rate for Payer: Riverside University Health System MISP |
$316.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.88
|
| Rate for Payer: United Healthcare All Other HMO |
$288.97
|
| Rate for Payer: United Healthcare HMO Rider |
$282.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.40
|
| Rate for Payer: Vantage Medical Group Senior |
$672.40
|
|
|
HC CNTRL VNS CATH KIT QL 8.5FR
|
Facility
|
OP
|
$752.56
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.51 |
| Max. Negotiated Rate |
$677.30 |
| Rate for Payer: Adventist Health Commercial |
$150.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$639.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$413.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$564.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$343.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$416.69
|
| Rate for Payer: Blue Shield of California Commercial |
$581.73
|
| Rate for Payer: Blue Shield of California EPN |
$379.29
|
| Rate for Payer: Cash Price |
$413.91
|
| Rate for Payer: Central Health Plan Commercial |
$602.05
|
| Rate for Payer: Cigna of CA HMO |
$526.79
|
| Rate for Payer: Cigna of CA PPO |
$526.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$639.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$639.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$639.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.02
|
| Rate for Payer: EPIC Health Plan Senior |
$301.02
|
| Rate for Payer: Galaxy Health WC |
$639.68
|
| Rate for Payer: Global Benefits Group Commercial |
$451.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$677.30
|
| Rate for Payer: InnovAge PACE Commercial |
$376.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$286.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$526.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$526.79
|
| Rate for Payer: Multiplan Commercial |
$564.42
|
| Rate for Payer: Networks By Design Commercial |
$376.28
|
| Rate for Payer: Prime Health Services Commercial |
$639.68
|
| Rate for Payer: Riverside University Health System MISP |
$301.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$451.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$451.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.44
|
| Rate for Payer: United Healthcare All Other HMO |
$274.91
|
| Rate for Payer: United Healthcare HMO Rider |
$268.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$639.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$639.68
|
| Rate for Payer: Vantage Medical Group Senior |
$639.68
|
|
|
HC CNTRL VNS CATH KIT QL 8.5FR
|
Facility
|
IP
|
$752.56
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.51 |
| Max. Negotiated Rate |
$677.30 |
| Rate for Payer: Adventist Health Commercial |
$150.51
|
| Rate for Payer: Blue Shield of California Commercial |
$581.73
|
| Rate for Payer: Blue Shield of California EPN |
$379.29
|
| Rate for Payer: Cash Price |
$413.91
|
| Rate for Payer: Central Health Plan Commercial |
$602.05
|
| Rate for Payer: Cigna of CA HMO |
$526.79
|
| Rate for Payer: Cigna of CA PPO |
$526.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.02
|
| Rate for Payer: EPIC Health Plan Senior |
$301.02
|
| Rate for Payer: Galaxy Health WC |
$639.68
|
| Rate for Payer: Global Benefits Group Commercial |
$451.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$677.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$286.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$465.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.51
|
| Rate for Payer: Multiplan Commercial |
$564.42
|
| Rate for Payer: Networks By Design Commercial |
$376.28
|
| Rate for Payer: Prime Health Services Commercial |
$639.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.44
|
| Rate for Payer: United Healthcare All Other HMO |
$274.91
|
| Rate for Payer: United Healthcare HMO Rider |
$268.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.46
|
|
|
HC CNTRL VNS CATH KIT TL 7FR 16CM
|
Facility
|
IP
|
$703.71
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.74 |
| Max. Negotiated Rate |
$633.34 |
| Rate for Payer: Adventist Health Commercial |
$140.74
|
| Rate for Payer: Cash Price |
$387.04
|
| Rate for Payer: Central Health Plan Commercial |
$562.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.48
|
| Rate for Payer: EPIC Health Plan Senior |
$281.48
|
| Rate for Payer: Galaxy Health WC |
$598.15
|
| Rate for Payer: Global Benefits Group Commercial |
$422.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$633.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$469.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$435.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.74
|
| Rate for Payer: Multiplan Commercial |
$527.78
|
| Rate for Payer: Networks By Design Commercial |
$457.41
|
| Rate for Payer: Prime Health Services Commercial |
$598.15
|
|
