|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$214.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$224.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.08
|
| Rate for Payer: Blue Distinction Transplant |
$57.60
|
| Rate for Payer: Blue Shield of California Commercial |
$59.33
|
| Rate for Payer: Blue Shield of California EPN |
$46.66
|
| Rate for Payer: Caremore Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.88
|
| Rate for Payer: Dignity Health Media |
$25.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.25
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$72.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| Rate for Payer: InnovAge PACE Commercial |
$37.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Prime Health Services Medicare |
$26.76
|
| Rate for Payer: Riverside University Health System MISP |
$27.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$285.30 |
| Rate for Payer: Cash Price |
$142.65
|
| Rate for Payer: Central Health Plan Commercial |
$253.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.80
|
| Rate for Payer: Galaxy Health WC |
$269.45
|
| Rate for Payer: Global Benefits Group Commercial |
$190.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$285.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$211.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.40
|
| Rate for Payer: Multiplan Commercial |
$237.75
|
| Rate for Payer: Networks By Design Commercial |
$206.05
|
| Rate for Payer: Prime Health Services Commercial |
$269.45
|
|
|
HC CATECHOLAMINES URINE FRACTIONATED
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900912199
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$224.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.08
|
| Rate for Payer: Blue Distinction Transplant |
$57.60
|
| Rate for Payer: Blue Shield of California Commercial |
$59.33
|
| Rate for Payer: Blue Shield of California EPN |
$46.66
|
| Rate for Payer: Caremore Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.88
|
| Rate for Payer: Dignity Health Media |
$25.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.25
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$72.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| Rate for Payer: InnovAge PACE Commercial |
$37.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Prime Health Services Medicare |
$26.76
|
| Rate for Payer: Riverside University Health System MISP |
$27.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC CATECHOLAMINES URINE FRACTIONATED
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900912199
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$285.30 |
| Rate for Payer: Cash Price |
$142.65
|
| Rate for Payer: Central Health Plan Commercial |
$253.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.80
|
| Rate for Payer: Galaxy Health WC |
$269.45
|
| Rate for Payer: Global Benefits Group Commercial |
$190.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$285.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$211.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.40
|
| Rate for Payer: Multiplan Commercial |
$237.75
|
| Rate for Payer: Networks By Design Commercial |
$206.05
|
| Rate for Payer: Prime Health Services Commercial |
$269.45
|
|
|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Blue Shield of California EPN |
$464.26
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.29
|
| Rate for Payer: United Healthcare All Other HMO |
$320.63
|
| Rate for Payer: United Healthcare HMO Rider |
$313.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$286.90
|
|
|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$396.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$484.26
|
| Rate for Payer: Blue Distinction Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$652.05
|
| Rate for Payer: Blue Shield of California EPN |
$472.95
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Media |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$652.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Riverside University Health System MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$396.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$484.26
|
| Rate for Payer: Blue Distinction Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$652.05
|
| Rate for Payer: Blue Shield of California EPN |
$472.95
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Media |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$652.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Riverside University Health System MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Blue Shield of California EPN |
$464.26
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.29
|
| Rate for Payer: United Healthcare All Other HMO |
$320.63
|
| Rate for Payer: United Healthcare HMO Rider |
$313.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$286.90
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
OP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$99.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.11
|
| Rate for Payer: Blue Distinction Transplant |
$66.12
|
| Rate for Payer: Blue Shield of California Commercial |
$69.32
|
| Rate for Payer: Blue Shield of California EPN |
$53.89
|
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: Central Health Plan Commercial |
$88.16
|
| Rate for Payer: Cigna of CA HMO |
$70.53
|
| Rate for Payer: Cigna of CA PPO |
$81.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.67
|
| Rate for Payer: Dignity Health Media |
$93.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.18
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$82.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.04
|
| Rate for Payer: Multiplan Commercial |
$82.65
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
| Rate for Payer: Riverside University Health System MISP |
$44.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.10
|
| Rate for Payer: United Healthcare All Other HMO |
$55.10
|
| Rate for Payer: United Healthcare HMO Rider |
$55.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.67
|
| Rate for Payer: Vantage Medical Group Senior |
$93.67
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
IP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$99.18 |
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: Central Health Plan Commercial |
$88.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.04
|
| Rate for Payer: Multiplan Commercial |
$82.65
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
IP
|
$590.09
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$118.02 |
| Max. Negotiated Rate |
$531.08 |
| Rate for Payer: Blue Shield of California EPN |
$315.11
|
| Rate for Payer: Cash Price |
$265.54
|
| Rate for Payer: Central Health Plan Commercial |
$472.07
|
| Rate for Payer: Cigna of CA HMO |
$413.06
|
| Rate for Payer: Cigna of CA PPO |
$413.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$236.04
|
| Rate for Payer: Galaxy Health WC |
$501.58
|
| Rate for Payer: Global Benefits Group Commercial |
$354.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.02
|
| Rate for Payer: Multiplan Commercial |
$442.57
|
| Rate for Payer: Prime Health Services Commercial |
$501.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$222.82
|
| Rate for Payer: United Healthcare All Other HMO |
$217.63
|
| Rate for Payer: United Healthcare HMO Rider |
$212.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$194.73
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
OP
|
$590.09
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$118.02 |
| Max. Negotiated Rate |
$531.08 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$501.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$269.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$328.68
|
| Rate for Payer: Blue Distinction Transplant |
$354.05
|
| Rate for Payer: Blue Shield of California Commercial |
$442.57
|
| Rate for Payer: Blue Shield of California EPN |
$321.01
|
| Rate for Payer: Cash Price |
$265.54
|
| Rate for Payer: Central Health Plan Commercial |
$472.07
|
| Rate for Payer: Cigna of CA HMO |
$413.06
|
| Rate for Payer: Cigna of CA PPO |
$413.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$501.58
|
| Rate for Payer: Dignity Health Media |
$501.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$501.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$236.04
|
| Rate for Payer: Galaxy Health WC |
$501.58
|
| Rate for Payer: Global Benefits Group Commercial |
$354.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.08
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$442.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.02
|
| Rate for Payer: Multiplan Commercial |
$442.57
|
| Rate for Payer: Networks By Design Commercial |
$295.04
|
| Rate for Payer: Prime Health Services Commercial |
$501.58
|
| Rate for Payer: Riverside University Health System MISP |
$236.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$354.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$354.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$295.04
|
| Rate for Payer: United Healthcare All Other HMO |
$295.04
|
| Rate for Payer: United Healthcare HMO Rider |
$295.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$501.58
|
| Rate for Payer: Vantage Medical Group Senior |
$501.58
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
OP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$891.14 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$841.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$544.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$544.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$452.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$551.51
|
| Rate for Payer: Blue Distinction Transplant |
$594.09
|
| Rate for Payer: Blue Shield of California Commercial |
$742.61
|
| Rate for Payer: Blue Shield of California EPN |
$538.64
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Central Health Plan Commercial |
$792.12
|
| Rate for Payer: Cigna of CA HMO |
$693.10
|
| Rate for Payer: Cigna of CA PPO |
$693.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$841.63
|
| Rate for Payer: Dignity Health Media |
$841.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$841.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$891.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$742.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$346.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.03
|
| Rate for Payer: Multiplan Commercial |
$742.61
|
| Rate for Payer: Networks By Design Commercial |
$495.08
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: Riverside University Health System MISP |
$396.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$594.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$594.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$495.08
|
| Rate for Payer: United Healthcare All Other HMO |
$495.08
|
| Rate for Payer: United Healthcare HMO Rider |
$495.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$841.63
|
| Rate for Payer: Vantage Medical Group Senior |
$841.63
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
IP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$891.14 |
| Rate for Payer: Blue Shield of California EPN |
$528.74
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Central Health Plan Commercial |
$792.12
|
| Rate for Payer: Cigna of CA HMO |
$693.10
|
| Rate for Payer: Cigna of CA PPO |
$693.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$891.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.03
|
| Rate for Payer: Multiplan Commercial |
$742.61
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$373.88
|
| Rate for Payer: United Healthcare All Other HMO |
$365.17
|
| Rate for Payer: United Healthcare HMO Rider |
$357.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.75
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
IP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,120.04 |
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,884.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,120.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,571.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$897.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.12
|
| Rate for Payer: Multiplan Commercial |
$1,766.70
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
OP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,120.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,430.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,295.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,295.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,140.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,391.69
|
| Rate for Payer: Blue Distinction Transplant |
$1,413.36
|
| Rate for Payer: Blue Shield of California Commercial |
$1,481.67
|
| Rate for Payer: Blue Shield of California EPN |
$1,151.89
|
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,884.48
|
| Rate for Payer: Cigna of CA HMO |
$1,507.58
|
| Rate for Payer: Cigna of CA PPO |
$1,743.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Dignity Health Media |
$2,002.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,002.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,120.04
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,766.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$824.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,571.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$897.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.12
|
| Rate for Payer: Multiplan Commercial |
$1,766.70
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
| Rate for Payer: Riverside University Health System MISP |
$942.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,413.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,413.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,177.80
|
| Rate for Payer: United Healthcare All Other HMO |
$1,177.80
|
| Rate for Payer: United Healthcare HMO Rider |
$1,177.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,177.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,002.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,002.26
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
OP
|
$377.81
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$229.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$321.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.21
|
| Rate for Payer: Blue Distinction Transplant |
$226.69
|
| Rate for Payer: Blue Shield of California Commercial |
$237.64
|
| Rate for Payer: Blue Shield of California EPN |
$184.75
|
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: Cigna of CA HMO |
$241.80
|
| Rate for Payer: Cigna of CA PPO |
$279.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$321.14
|
| Rate for Payer: Dignity Health Media |
$321.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$321.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$283.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$132.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
| Rate for Payer: Riverside University Health System MISP |
$151.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.90
|
| Rate for Payer: United Healthcare All Other HMO |
$188.90
|
| Rate for Payer: United Healthcare HMO Rider |
$188.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$321.14
|
| Rate for Payer: Vantage Medical Group Senior |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
IP
|
$377.81
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
OP
|
$377.81
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$229.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$321.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.21
|
| Rate for Payer: Blue Distinction Transplant |
$226.69
|
| Rate for Payer: Blue Shield of California Commercial |
$237.64
|
| Rate for Payer: Blue Shield of California EPN |
$184.75
|
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: Cigna of CA HMO |
$241.80
|
| Rate for Payer: Cigna of CA PPO |
$279.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$321.14
|
| Rate for Payer: Dignity Health Media |
$321.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$321.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$283.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$132.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
| Rate for Payer: Riverside University Health System MISP |
$151.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.90
|
| Rate for Payer: United Healthcare All Other HMO |
$188.90
|
| Rate for Payer: United Healthcare HMO Rider |
$188.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$321.14
|
| Rate for Payer: Vantage Medical Group Senior |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
IP
|
$377.81
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
IP
|
$377.81
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
OP
|
$377.81
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$229.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$321.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.21
|
| Rate for Payer: Blue Distinction Transplant |
$226.69
|
| Rate for Payer: Blue Shield of California Commercial |
$237.64
|
| Rate for Payer: Blue Shield of California EPN |
$184.75
|
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: Cigna of CA HMO |
$241.80
|
| Rate for Payer: Cigna of CA PPO |
$279.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$321.14
|
| Rate for Payer: Dignity Health Media |
$321.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$321.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$283.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$132.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
| Rate for Payer: Riverside University Health System MISP |
$151.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.90
|
| Rate for Payer: United Healthcare All Other HMO |
$188.90
|
| Rate for Payer: United Healthcare HMO Rider |
$188.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$321.14
|
| Rate for Payer: Vantage Medical Group Senior |
$321.14
|
|
|
HC CATH AIRWAY EXCHANGE 8FR
|
Facility
|
OP
|
$377.81
|
|
| Hospital Charge Code |
901603693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$229.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$321.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.21
|
| Rate for Payer: Blue Distinction Transplant |
$226.69
|
| Rate for Payer: Blue Shield of California Commercial |
$237.64
|
| Rate for Payer: Blue Shield of California EPN |
$184.75
|
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: Cigna of CA HMO |
$241.80
|
| Rate for Payer: Cigna of CA PPO |
$279.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$321.14
|
| Rate for Payer: Dignity Health Media |
$321.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$321.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$283.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$132.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
| Rate for Payer: Riverside University Health System MISP |
$151.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.90
|
| Rate for Payer: United Healthcare All Other HMO |
$188.90
|
| Rate for Payer: United Healthcare HMO Rider |
$188.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$321.14
|
| Rate for Payer: Vantage Medical Group Senior |
$321.14
|
|
