|
HC CATH CATALYST THROM
|
Facility
|
OP
|
$5,625.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,125.00 |
| Max. Negotiated Rate |
$5,062.50 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,781.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,093.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,093.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,568.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,133.12
|
| Rate for Payer: Blue Distinction Transplant |
$3,375.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,218.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,060.00
|
| Rate for Payer: Cash Price |
$2,531.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,500.00
|
| Rate for Payer: Cigna of CA HMO |
$3,937.50
|
| Rate for Payer: Cigna of CA PPO |
$3,937.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,781.25
|
| Rate for Payer: Dignity Health Media |
$4,781.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,781.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,250.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,250.00
|
| Rate for Payer: Galaxy Health WC |
$4,781.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,375.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,062.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,218.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,968.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,751.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,143.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,125.00
|
| Rate for Payer: Multiplan Commercial |
$4,218.75
|
| Rate for Payer: Networks By Design Commercial |
$2,812.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,781.25
|
| Rate for Payer: Riverside University Health System MISP |
$2,250.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,375.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,375.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,812.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,812.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,812.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,812.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,781.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,781.25
|
|
|
HC CATH CEREBROFLO EVD KIT 10FR
|
Facility
|
IP
|
$2,843.10
|
|
| Hospital Charge Code |
901698291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$568.62 |
| Max. Negotiated Rate |
$2,558.79 |
| Rate for Payer: Cash Price |
$1,279.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,274.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,137.24
|
| Rate for Payer: Galaxy Health WC |
$2,416.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,705.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,558.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,896.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,083.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$568.62
|
| Rate for Payer: Multiplan Commercial |
$2,132.32
|
| Rate for Payer: Networks By Design Commercial |
$1,848.02
|
| Rate for Payer: Prime Health Services Commercial |
$2,416.64
|
|
|
HC CATH CEREBROFLO EVD KIT 10FR
|
Facility
|
OP
|
$2,843.10
|
|
| Hospital Charge Code |
901698291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$568.62 |
| Max. Negotiated Rate |
$2,558.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,726.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,416.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,563.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,563.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,376.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,679.70
|
| Rate for Payer: Blue Distinction Transplant |
$1,705.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,788.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,390.28
|
| Rate for Payer: Cash Price |
$1,279.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,274.48
|
| Rate for Payer: Cigna of CA HMO |
$1,819.58
|
| Rate for Payer: Cigna of CA PPO |
$2,103.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,416.64
|
| Rate for Payer: Dignity Health Media |
$2,416.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,416.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,137.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,137.24
|
| Rate for Payer: Galaxy Health WC |
$2,416.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,705.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,558.79
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,132.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$995.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,896.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,083.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$568.62
|
| Rate for Payer: Multiplan Commercial |
$2,132.32
|
| Rate for Payer: Networks By Design Commercial |
$1,848.02
|
| Rate for Payer: Prime Health Services Commercial |
$2,416.64
|
| Rate for Payer: Riverside University Health System MISP |
$1,137.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,705.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,705.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,421.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,421.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,421.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,421.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,416.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,416.64
|
|
|
HC CATH CHEST 9.6FR INFANT
|
Facility
|
IP
|
$152.00
|
|
| Hospital Charge Code |
901602295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC CATH CHEST 9.6FR INFANT
|
Facility
|
OP
|
$152.00
|
|
| Hospital Charge Code |
901602295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.80
|
| Rate for Payer: Blue Distinction Transplant |
$91.20
|
| Rate for Payer: Blue Shield of California Commercial |
$95.61
|
| Rate for Payer: Blue Shield of California EPN |
$74.33
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Media |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$114.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC CATH CLEANER THROM
|
Facility
|
IP
|
$3,438.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$3,094.20 |
| Rate for Payer: Blue Shield of California EPN |
$1,835.89
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Cigna of CA HMO |
$2,406.60
|
| Rate for Payer: Cigna of CA PPO |
$2,406.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,375.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,375.20
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,293.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,309.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,298.19
|
| Rate for Payer: United Healthcare All Other HMO |
$1,267.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1,240.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,134.54
|
|
|
HC CATH CLEANER THROM
|
Facility
|
OP
|
$3,438.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$3,094.20 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,922.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,890.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,890.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,569.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,914.97
|
| Rate for Payer: Blue Distinction Transplant |
$2,062.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,578.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,870.27
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Cigna of CA HMO |
$2,406.60
|
| Rate for Payer: Cigna of CA PPO |
$2,406.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,922.30
|
| Rate for Payer: Dignity Health Media |
$2,922.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,922.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,375.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,375.20
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,578.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,203.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,293.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,309.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Networks By Design Commercial |
$1,719.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
| Rate for Payer: Riverside University Health System MISP |
$1,375.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,062.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,062.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,922.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,922.30
|
|
|
HC CATH CLOSED SUCTION 10FR
|
Facility
|
OP
|
$106.10
|
|
| Hospital Charge Code |
901605543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.68
|
| Rate for Payer: Blue Distinction Transplant |
$63.66
|
| Rate for Payer: Blue Shield of California Commercial |
$66.74
|
| Rate for Payer: Blue Shield of California EPN |
$51.88
|
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: Cigna of CA HMO |
$67.90
|
| Rate for Payer: Cigna of CA PPO |
$78.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.18
|
| Rate for Payer: Dignity Health Media |
$90.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$79.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
| Rate for Payer: Riverside University Health System MISP |
$42.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.05
|
| Rate for Payer: United Healthcare All Other HMO |
$53.05
|
| Rate for Payer: United Healthcare HMO Rider |
$53.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.18
|
| Rate for Payer: Vantage Medical Group Senior |
$90.18
|
|
|
HC CATH CLOSED SUCTION 10FR
|
Facility
|
IP
|
$106.10
|
|
| Hospital Charge Code |
901605543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
|
|
HC CATH CLOSED SUCTION 14FR 24HR
|
Facility
|
OP
|
$118.10
|
|
| Hospital Charge Code |
901602438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$106.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.77
|
| Rate for Payer: Blue Distinction Transplant |
$70.86
|
| Rate for Payer: Blue Shield of California Commercial |
$74.28
|
| Rate for Payer: Blue Shield of California EPN |
$57.75
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Central Health Plan Commercial |
$94.48
|
| Rate for Payer: Cigna of CA HMO |
$75.58
|
| Rate for Payer: Cigna of CA PPO |
$87.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.38
|
| Rate for Payer: Dignity Health Media |
$100.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.24
|
| Rate for Payer: Galaxy Health WC |
$100.38
|
| Rate for Payer: Global Benefits Group Commercial |
$70.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$106.29
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$88.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.62
|
| Rate for Payer: Multiplan Commercial |
$88.58
|
| Rate for Payer: Networks By Design Commercial |
$76.76
|
| Rate for Payer: Prime Health Services Commercial |
$100.38
|
| Rate for Payer: Riverside University Health System MISP |
$47.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.05
|
| Rate for Payer: United Healthcare All Other HMO |
$59.05
|
| Rate for Payer: United Healthcare HMO Rider |
$59.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.38
|
| Rate for Payer: Vantage Medical Group Senior |
$100.38
|
|
|
HC CATH CLOSED SUCTION 14FR 24HR
|
Facility
|
IP
|
$118.10
|
|
| Hospital Charge Code |
901602438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$106.29 |
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Central Health Plan Commercial |
$94.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.24
|
| Rate for Payer: Galaxy Health WC |
$100.38
|
| Rate for Payer: Global Benefits Group Commercial |
$70.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$106.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.62
|
| Rate for Payer: Multiplan Commercial |
$88.58
|
| Rate for Payer: Networks By Design Commercial |
$76.76
|
| Rate for Payer: Prime Health Services Commercial |
$100.38
|
|
|
HC CATH CLOSED SUCTION 5FR
|
Facility
|
OP
|
$94.92
|
|
| Hospital Charge Code |
901604306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.08
|
| Rate for Payer: Blue Distinction Transplant |
$56.95
|
| Rate for Payer: Blue Shield of California Commercial |
$59.70
|
| Rate for Payer: Blue Shield of California EPN |
$46.42
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: Cigna of CA HMO |
$60.75
|
| Rate for Payer: Cigna of CA PPO |
$70.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.68
|
| Rate for Payer: Dignity Health Media |
$80.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
| Rate for Payer: Riverside University Health System MISP |
$37.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.46
|
| Rate for Payer: United Healthcare All Other HMO |
$47.46
|
| Rate for Payer: United Healthcare HMO Rider |
$47.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.68
|
| Rate for Payer: Vantage Medical Group Senior |
$80.68
|
|
|
HC CATH CLOSED SUCTION 5FR
|
Facility
|
IP
|
$94.92
|
|
| Hospital Charge Code |
901604306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
|
|
HC CATH CLOSED SUCTION 6FR
|
Facility
|
OP
|
$94.92
|
|
| Hospital Charge Code |
901604307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.08
|
| Rate for Payer: Blue Distinction Transplant |
$56.95
|
| Rate for Payer: Blue Shield of California Commercial |
$59.70
|
| Rate for Payer: Blue Shield of California EPN |
$46.42
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: Cigna of CA HMO |
$60.75
|
| Rate for Payer: Cigna of CA PPO |
$70.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.68
|
| Rate for Payer: Dignity Health Media |
$80.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
| Rate for Payer: Riverside University Health System MISP |
$37.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.46
|
| Rate for Payer: United Healthcare All Other HMO |
$47.46
|
| Rate for Payer: United Healthcare HMO Rider |
$47.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.68
|
| Rate for Payer: Vantage Medical Group Senior |
$80.68
|
|
|
HC CATH CLOSED SUCTION 6FR
|
Facility
|
IP
|
$94.92
|
|
| Hospital Charge Code |
901604307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
|
|
HC CATH CLOSED SUCTION 6FR ELBOW
|
Facility
|
IP
|
$106.10
|
|
| Hospital Charge Code |
901604317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
|
|
HC CATH CLOSED SUCTION 6FR ELBOW
|
Facility
|
OP
|
$106.10
|
|
| Hospital Charge Code |
901604317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.68
|
| Rate for Payer: Blue Distinction Transplant |
$63.66
|
| Rate for Payer: Blue Shield of California Commercial |
$66.74
|
| Rate for Payer: Blue Shield of California EPN |
$51.88
|
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: Cigna of CA HMO |
$67.90
|
| Rate for Payer: Cigna of CA PPO |
$78.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.18
|
| Rate for Payer: Dignity Health Media |
$90.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$79.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
| Rate for Payer: Riverside University Health System MISP |
$42.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.05
|
| Rate for Payer: United Healthcare All Other HMO |
$53.05
|
| Rate for Payer: United Healthcare HMO Rider |
$53.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.18
|
| Rate for Payer: Vantage Medical Group Senior |
$90.18
|
|
|
HC CATH CLOSED SUCTION 8FR
|
Facility
|
OP
|
$94.92
|
|
| Hospital Charge Code |
901604312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.08
|
| Rate for Payer: Blue Distinction Transplant |
$56.95
|
| Rate for Payer: Blue Shield of California Commercial |
$59.70
|
| Rate for Payer: Blue Shield of California EPN |
$46.42
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: Cigna of CA HMO |
$60.75
|
| Rate for Payer: Cigna of CA PPO |
$70.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.68
|
| Rate for Payer: Dignity Health Media |
$80.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
| Rate for Payer: Riverside University Health System MISP |
$37.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.46
|
| Rate for Payer: United Healthcare All Other HMO |
$47.46
|
| Rate for Payer: United Healthcare HMO Rider |
$47.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.68
|
| Rate for Payer: Vantage Medical Group Senior |
$80.68
|
|
|
HC CATH CLOSED SUCTION 8FR
|
Facility
|
IP
|
$94.92
|
|
| Hospital Charge Code |
901604312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
|
|
HC CATH CLOSED SUCTION 8FRELBOW
|
Facility
|
OP
|
$106.10
|
|
| Hospital Charge Code |
901604320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.68
|
| Rate for Payer: Blue Distinction Transplant |
$63.66
|
| Rate for Payer: Blue Shield of California Commercial |
$66.74
|
| Rate for Payer: Blue Shield of California EPN |
$51.88
|
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: Cigna of CA HMO |
$67.90
|
| Rate for Payer: Cigna of CA PPO |
$78.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.18
|
| Rate for Payer: Dignity Health Media |
$90.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$79.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
| Rate for Payer: Riverside University Health System MISP |
$42.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.05
|
| Rate for Payer: United Healthcare All Other HMO |
$53.05
|
| Rate for Payer: United Healthcare HMO Rider |
$53.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.18
|
| Rate for Payer: Vantage Medical Group Senior |
$90.18
|
|
|
HC CATH CLOSED SUCTION 8FRELBOW
|
Facility
|
IP
|
$106.10
|
|
| Hospital Charge Code |
901604320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$95.49 |
| Rate for Payer: Cash Price |
$47.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.44
|
| Rate for Payer: Galaxy Health WC |
$90.18
|
| Rate for Payer: Global Benefits Group Commercial |
$63.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.22
|
| Rate for Payer: Multiplan Commercial |
$79.58
|
| Rate for Payer: Networks By Design Commercial |
$68.96
|
| Rate for Payer: Prime Health Services Commercial |
$90.18
|
|
|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
OP
|
$94.92
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.08
|
| Rate for Payer: Blue Distinction Transplant |
$56.95
|
| Rate for Payer: Blue Shield of California Commercial |
$59.70
|
| Rate for Payer: Blue Shield of California EPN |
$46.42
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: Cigna of CA HMO |
$60.75
|
| Rate for Payer: Cigna of CA PPO |
$70.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.68
|
| Rate for Payer: Dignity Health Media |
$80.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
| Rate for Payer: Riverside University Health System MISP |
$37.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.46
|
| Rate for Payer: United Healthcare All Other HMO |
$47.46
|
| Rate for Payer: United Healthcare HMO Rider |
$47.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.68
|
| Rate for Payer: Vantage Medical Group Senior |
$80.68
|
|
|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
IP
|
$94.92
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$85.43 |
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Central Health Plan Commercial |
$75.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.97
|
| Rate for Payer: Galaxy Health WC |
$80.68
|
| Rate for Payer: Global Benefits Group Commercial |
$56.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.98
|
| Rate for Payer: Multiplan Commercial |
$71.19
|
| Rate for Payer: Networks By Design Commercial |
$61.70
|
| Rate for Payer: Prime Health Services Commercial |
$80.68
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
IP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$521.48 |
| Rate for Payer: Blue Shield of California EPN |
$309.41
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Central Health Plan Commercial |
$463.54
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$521.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.88
|
| Rate for Payer: Multiplan Commercial |
$434.56
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$218.79
|
| Rate for Payer: United Healthcare All Other HMO |
$213.69
|
| Rate for Payer: United Healthcare HMO Rider |
$209.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.21
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
OP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$521.48 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$492.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$318.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$318.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$322.74
|
| Rate for Payer: Blue Distinction Transplant |
$347.65
|
| Rate for Payer: Blue Shield of California Commercial |
$434.56
|
| Rate for Payer: Blue Shield of California EPN |
$315.20
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Central Health Plan Commercial |
$463.54
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$492.51
|
| Rate for Payer: Dignity Health Media |
$492.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$492.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$521.48
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$434.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.88
|
| Rate for Payer: Multiplan Commercial |
$434.56
|
| Rate for Payer: Networks By Design Commercial |
$289.71
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: Riverside University Health System MISP |
$231.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$347.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$347.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.71
|
| Rate for Payer: United Healthcare All Other HMO |
$289.71
|
| Rate for Payer: United Healthcare HMO Rider |
$289.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$289.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$492.51
|
| Rate for Payer: Vantage Medical Group Senior |
$492.51
|
|
