|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| 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 |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| 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 |
$290.00
|
| 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 CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
OP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.12
|
| Rate for Payer: Blue Distinction Transplant |
$4.18
|
| Rate for Payer: Blue Shield of California Commercial |
$4.38
|
| Rate for Payer: Blue Shield of California EPN |
$3.41
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Media |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
IP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$6.27 |
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Central Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.39
|
| Rate for Payer: Multiplan Commercial |
$5.23
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
|
|
HC CATH COOK CORONARY
|
Facility
|
OP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$153.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$138.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.88
|
| Rate for Payer: Blue Distinction Transplant |
$151.20
|
| Rate for Payer: Blue Shield of California Commercial |
$158.51
|
| Rate for Payer: Blue Shield of California EPN |
$123.23
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: Cigna of CA HMO |
$161.28
|
| Rate for Payer: Cigna of CA PPO |
$186.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Media |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$189.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Riverside University Health System MISP |
$100.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$126.00
|
| Rate for Payer: United Healthcare All Other HMO |
$126.00
|
| Rate for Payer: United Healthcare HMO Rider |
$126.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC CATH COOK CORONARY
|
Facility
|
IP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Central Health Plan Commercial |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$226.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$189.00
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.01
|
| Rate for Payer: Blue Distinction Transplant |
$89.38
|
| Rate for Payer: Blue Shield of California Commercial |
$93.70
|
| Rate for Payer: Blue Shield of California EPN |
$72.84
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Media |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$111.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$52.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Riverside University Health System MISP |
$59.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$134.06 |
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Central Health Plan Commercial |
$119.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$134.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$111.72
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
OP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.82
|
| Rate for Payer: Blue Distinction Transplant |
$82.08
|
| Rate for Payer: Blue Shield of California Commercial |
$86.05
|
| Rate for Payer: Blue Shield of California EPN |
$66.90
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: Cigna of CA HMO |
$87.55
|
| Rate for Payer: Cigna of CA PPO |
$101.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.28
|
| Rate for Payer: Dignity Health Media |
$116.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$102.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
| Rate for Payer: Riverside University Health System MISP |
$54.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.40
|
| Rate for Payer: United Healthcare All Other HMO |
$68.40
|
| Rate for Payer: United Healthcare HMO Rider |
$68.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.28
|
| Rate for Payer: Vantage Medical Group Senior |
$116.28
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
IP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Central Health Plan Commercial |
$109.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$102.60
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
OP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$382.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$382.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$410.91
|
| Rate for Payer: Blue Distinction Transplant |
$417.31
|
| Rate for Payer: Blue Shield of California Commercial |
$437.48
|
| Rate for Payer: Blue Shield of California EPN |
$340.11
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: Cigna of CA HMO |
$445.13
|
| Rate for Payer: Cigna of CA PPO |
$514.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$591.19
|
| Rate for Payer: Dignity Health Media |
$591.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$591.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$521.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$243.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
| Rate for Payer: Riverside University Health System MISP |
$278.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$417.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$417.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.76
|
| Rate for Payer: United Healthcare All Other HMO |
$347.76
|
| Rate for Payer: United Healthcare HMO Rider |
$347.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$347.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$591.19
|
| Rate for Payer: Vantage Medical Group Senior |
$591.19
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
IP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$625.97 |
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Central Health Plan Commercial |
$556.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$625.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.10
|
| Rate for Payer: Multiplan Commercial |
$521.64
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
|
|
HC CATH COUDE 12FR
|
Facility
|
IP
|
$33.78
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$30.40 |
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Central Health Plan Commercial |
$27.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: Galaxy Health WC |
$28.71
|
| Rate for Payer: Global Benefits Group Commercial |
$20.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.76
|
| Rate for Payer: Multiplan Commercial |
$25.34
|
| Rate for Payer: Networks By Design Commercial |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$28.71
|
|
|
HC CATH COUDE 12FR
|
Facility
|
OP
|
$33.78
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.96
|
| Rate for Payer: Blue Distinction Transplant |
$20.27
|
| Rate for Payer: Blue Shield of California Commercial |
$21.25
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Central Health Plan Commercial |
$27.02
|
| Rate for Payer: Cigna of CA HMO |
$21.62
|
| Rate for Payer: Cigna of CA PPO |
$25.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.71
|
| Rate for Payer: Dignity Health Media |
$28.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.51
|
| Rate for Payer: Galaxy Health WC |
$28.71
|
| Rate for Payer: Global Benefits Group Commercial |
$20.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.76
|
| Rate for Payer: Multiplan Commercial |
$25.34
|
| Rate for Payer: Networks By Design Commercial |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$28.71
|
| Rate for Payer: Riverside University Health System MISP |
$13.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.71
|
| Rate for Payer: Vantage Medical Group Senior |
$28.71
|
|
|
HC CATH COUDE 14FR
|
Facility
|
OP
|
$29.85
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.64
|
| Rate for Payer: Blue Distinction Transplant |
$17.91
|
| Rate for Payer: Blue Shield of California Commercial |
$18.78
|
| Rate for Payer: Blue Shield of California EPN |
$14.60
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: Cigna of CA HMO |
$19.10
|
| Rate for Payer: Cigna of CA PPO |
$22.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.37
|
| Rate for Payer: Dignity Health Media |
$25.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
| Rate for Payer: Riverside University Health System MISP |
$11.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.92
|
| Rate for Payer: United Healthcare All Other HMO |
$14.92
|
| Rate for Payer: United Healthcare HMO Rider |
$14.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.37
|
| Rate for Payer: Vantage Medical Group Senior |
$25.37
|
|
|
HC CATH COUDE 14FR
|
Facility
|
IP
|
$29.85
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$26.86 |
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
|
|
HC CATH COUDE 18FR
|
Facility
|
OP
|
$29.85
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.64
|
| Rate for Payer: Blue Distinction Transplant |
$17.91
|
| Rate for Payer: Blue Shield of California Commercial |
$18.78
|
| Rate for Payer: Blue Shield of California EPN |
$14.60
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: Cigna of CA HMO |
$19.10
|
| Rate for Payer: Cigna of CA PPO |
$22.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.37
|
| Rate for Payer: Dignity Health Media |
$25.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
| Rate for Payer: Riverside University Health System MISP |
$11.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.92
|
| Rate for Payer: United Healthcare All Other HMO |
$14.92
|
| Rate for Payer: United Healthcare HMO Rider |
$14.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.37
|
| Rate for Payer: Vantage Medical Group Senior |
$25.37
|
|
|
HC CATH COUDE 18FR
|
Facility
|
IP
|
$29.85
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$26.86 |
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
|
|
HC CATH COUDE 20FR
|
Facility
|
OP
|
$32.80
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.38
|
| Rate for Payer: Blue Distinction Transplant |
$19.68
|
| Rate for Payer: Blue Shield of California Commercial |
$20.63
|
| Rate for Payer: Blue Shield of California EPN |
$16.04
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: Cigna of CA HMO |
$20.99
|
| Rate for Payer: Cigna of CA PPO |
$24.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.88
|
| Rate for Payer: Dignity Health Media |
$27.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
| Rate for Payer: Riverside University Health System MISP |
$13.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.40
|
| Rate for Payer: United Healthcare All Other HMO |
$16.40
|
| Rate for Payer: United Healthcare HMO Rider |
$16.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.88
|
| Rate for Payer: Vantage Medical Group Senior |
$27.88
|
|
|
HC CATH COUDE 20FR
|
Facility
|
IP
|
$32.80
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$29.52 |
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
IP
|
$33.78
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$30.40 |
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Central Health Plan Commercial |
$27.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: Galaxy Health WC |
$28.71
|
| Rate for Payer: Global Benefits Group Commercial |
$20.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.76
|
| Rate for Payer: Multiplan Commercial |
$25.34
|
| Rate for Payer: Networks By Design Commercial |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$28.71
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
OP
|
$33.78
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.96
|
| Rate for Payer: Blue Distinction Transplant |
$20.27
|
| Rate for Payer: Blue Shield of California Commercial |
$21.25
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Central Health Plan Commercial |
$27.02
|
| Rate for Payer: Cigna of CA HMO |
$21.62
|
| Rate for Payer: Cigna of CA PPO |
$25.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.71
|
| Rate for Payer: Dignity Health Media |
$28.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.51
|
| Rate for Payer: Galaxy Health WC |
$28.71
|
| Rate for Payer: Global Benefits Group Commercial |
$20.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.76
|
| Rate for Payer: Multiplan Commercial |
$25.34
|
| Rate for Payer: Networks By Design Commercial |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$28.71
|
| Rate for Payer: Riverside University Health System MISP |
$13.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.71
|
| Rate for Payer: Vantage Medical Group Senior |
$28.71
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
OP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.29
|
| Rate for Payer: Blue Distinction Transplant |
$28.73
|
| Rate for Payer: Blue Shield of California Commercial |
$30.12
|
| Rate for Payer: Blue Shield of California EPN |
$23.42
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: Cigna of CA HMO |
$30.65
|
| Rate for Payer: Cigna of CA PPO |
$35.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.71
|
| Rate for Payer: Dignity Health Media |
$40.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
| Rate for Payer: Riverside University Health System MISP |
$19.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.94
|
| Rate for Payer: United Healthcare All Other HMO |
$23.94
|
| Rate for Payer: United Healthcare HMO Rider |
$23.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.71
|
| Rate for Payer: Vantage Medical Group Senior |
$40.71
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
IP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
OP
|
$898.20
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.64 |
| Max. Negotiated Rate |
$808.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$545.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$763.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$494.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$434.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.66
|
| Rate for Payer: Blue Distinction Transplant |
$538.92
|
| Rate for Payer: Blue Shield of California Commercial |
$564.97
|
| Rate for Payer: Blue Shield of California EPN |
$439.22
|
| Rate for Payer: Cash Price |
$404.19
|
| Rate for Payer: Central Health Plan Commercial |
$718.56
|
| Rate for Payer: Cigna of CA HMO |
$574.85
|
| Rate for Payer: Cigna of CA PPO |
$664.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$763.47
|
| Rate for Payer: Dignity Health Media |
$763.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$359.28
|
| Rate for Payer: Galaxy Health WC |
$763.47
|
| Rate for Payer: Global Benefits Group Commercial |
$538.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$673.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$599.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.64
|
| Rate for Payer: Multiplan Commercial |
$673.65
|
| Rate for Payer: Networks By Design Commercial |
$583.83
|
| Rate for Payer: Prime Health Services Commercial |
$763.47
|
| Rate for Payer: Riverside University Health System MISP |
$359.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$538.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$538.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$449.10
|
| Rate for Payer: United Healthcare All Other HMO |
$449.10
|
| Rate for Payer: United Healthcare HMO Rider |
$449.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$449.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.47
|
| Rate for Payer: Vantage Medical Group Senior |
$763.47
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
IP
|
$898.20
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.64 |
| Max. Negotiated Rate |
$808.38 |
| Rate for Payer: Cash Price |
$404.19
|
| Rate for Payer: Central Health Plan Commercial |
$718.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.28
|
| Rate for Payer: Galaxy Health WC |
$763.47
|
| Rate for Payer: Global Benefits Group Commercial |
$538.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$599.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.64
|
| Rate for Payer: Multiplan Commercial |
$673.65
|
| Rate for Payer: Networks By Design Commercial |
$583.83
|
| Rate for Payer: Prime Health Services Commercial |
$763.47
|
|
