|
HC CATH DRAIN EXTERNAL
|
Facility
|
IP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Cash Price |
$398.19
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$590.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
OP
|
$726.34
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.27 |
| Max. Negotiated Rate |
$653.71 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$617.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$399.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$331.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$404.57
|
| Rate for Payer: Blue Distinction Transplant |
$435.80
|
| Rate for Payer: Blue Shield of California Commercial |
$544.76
|
| Rate for Payer: Blue Shield of California EPN |
$395.13
|
| Rate for Payer: Cash Price |
$326.85
|
| Rate for Payer: Central Health Plan Commercial |
$581.07
|
| Rate for Payer: Cigna of CA HMO |
$508.44
|
| Rate for Payer: Cigna of CA PPO |
$508.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$617.39
|
| Rate for Payer: Dignity Health Media |
$617.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$617.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$290.54
|
| Rate for Payer: Galaxy Health WC |
$617.39
|
| Rate for Payer: Global Benefits Group Commercial |
$435.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$653.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$544.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.27
|
| Rate for Payer: Multiplan Commercial |
$544.76
|
| Rate for Payer: Networks By Design Commercial |
$363.17
|
| Rate for Payer: Prime Health Services Commercial |
$617.39
|
| Rate for Payer: Riverside University Health System MISP |
$290.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$435.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$435.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$363.17
|
| Rate for Payer: United Healthcare All Other HMO |
$363.17
|
| Rate for Payer: United Healthcare HMO Rider |
$363.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$363.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$617.39
|
| Rate for Payer: Vantage Medical Group Senior |
$617.39
|
|
|
HC CATH DRAIN LUMBAR INTGRA 80CM
|
Facility
|
IP
|
$726.34
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.27 |
| Max. Negotiated Rate |
$653.71 |
| Rate for Payer: Blue Shield of California EPN |
$387.87
|
| Rate for Payer: Cash Price |
$326.85
|
| Rate for Payer: Central Health Plan Commercial |
$581.07
|
| Rate for Payer: Cigna of CA HMO |
$508.44
|
| Rate for Payer: Cigna of CA PPO |
$508.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$290.54
|
| Rate for Payer: Galaxy Health WC |
$617.39
|
| Rate for Payer: Global Benefits Group Commercial |
$435.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$653.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.27
|
| Rate for Payer: Multiplan Commercial |
$544.76
|
| Rate for Payer: Prime Health Services Commercial |
$617.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$274.27
|
| Rate for Payer: United Healthcare All Other HMO |
$267.87
|
| Rate for Payer: United Healthcare HMO Rider |
$262.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$239.69
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.53 |
| Max. Negotiated Rate |
$560.39 |
| Rate for Payer: Blue Shield of California EPN |
$332.50
|
| Rate for Payer: Cash Price |
$280.20
|
| Rate for Payer: Central Health Plan Commercial |
$498.13
|
| Rate for Payer: Cigna of CA HMO |
$435.86
|
| Rate for Payer: Cigna of CA PPO |
$435.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$249.06
|
| Rate for Payer: Galaxy Health WC |
$529.26
|
| Rate for Payer: Global Benefits Group Commercial |
$373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$560.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$415.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.53
|
| Rate for Payer: Multiplan Commercial |
$467.00
|
| Rate for Payer: Prime Health Services Commercial |
$529.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$235.12
|
| Rate for Payer: United Healthcare All Other HMO |
$229.64
|
| Rate for Payer: United Healthcare HMO Rider |
$224.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$205.48
|
|
|
HC CATH DRAIN PER-Q CAVTY 14FR*
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603300
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.53 |
| Max. Negotiated Rate |
$560.39 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$529.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$342.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$342.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$284.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$346.82
|
| Rate for Payer: Blue Distinction Transplant |
$373.60
|
| Rate for Payer: Blue Shield of California Commercial |
$467.00
|
| Rate for Payer: Blue Shield of California EPN |
$338.73
|
| Rate for Payer: Cash Price |
$280.20
|
| Rate for Payer: Central Health Plan Commercial |
$498.13
|
| Rate for Payer: Cigna of CA HMO |
$435.86
|
| Rate for Payer: Cigna of CA PPO |
$435.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$529.26
|
| Rate for Payer: Dignity Health Media |
$529.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$529.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$249.06
|
| Rate for Payer: Galaxy Health WC |
$529.26
|
| Rate for Payer: Global Benefits Group Commercial |
$373.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$560.39
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$467.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$217.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$415.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.53
|
| Rate for Payer: Multiplan Commercial |
$467.00
|
| Rate for Payer: Networks By Design Commercial |
$311.33
|
| Rate for Payer: Prime Health Services Commercial |
$529.26
|
| Rate for Payer: Riverside University Health System MISP |
$249.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$373.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$373.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$311.33
|
| Rate for Payer: United Healthcare All Other HMO |
$311.33
|
| Rate for Payer: United Healthcare HMO Rider |
$311.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$311.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$529.26
|
| Rate for Payer: Vantage Medical Group Senior |
$529.26
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
IP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Multiplan Commercial |
$442.64
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
|
|
HC CATH DRAIN PNEUMOPERIC 5FR
|
Facility
|
OP
|
$590.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.04 |
| Max. Negotiated Rate |
$531.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$501.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$285.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$348.68
|
| Rate for Payer: Blue Distinction Transplant |
$354.11
|
| Rate for Payer: Blue Shield of California Commercial |
$371.22
|
| Rate for Payer: Blue Shield of California EPN |
$288.60
|
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Cash Price |
$265.58
|
| Rate for Payer: Central Health Plan Commercial |
$472.14
|
| Rate for Payer: Cigna of CA HMO |
$377.72
|
| Rate for Payer: Cigna of CA PPO |
$436.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$501.65
|
| Rate for Payer: Dignity Health Media |
$501.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$501.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$236.07
|
| Rate for Payer: Galaxy Health WC |
$501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$354.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$531.16
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$442.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$206.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$393.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$224.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.04
|
| Rate for Payer: Multiplan Commercial |
$442.64
|
| Rate for Payer: Networks By Design Commercial |
$383.62
|
| Rate for Payer: Prime Health Services Commercial |
$501.65
|
| Rate for Payer: Riverside University Health System MISP |
$236.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$354.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$354.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$295.09
|
| Rate for Payer: United Healthcare All Other HMO |
$295.09
|
| Rate for Payer: United Healthcare HMO Rider |
$295.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$501.65
|
| Rate for Payer: Vantage Medical Group Senior |
$501.65
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
IP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Cash Price |
$135.80
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
|
|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
OP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$271.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$183.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$178.29
|
| Rate for Payer: Blue Distinction Transplant |
$181.06
|
| Rate for Payer: Blue Shield of California Commercial |
$189.81
|
| Rate for Payer: Blue Shield of California EPN |
$147.57
|
| Rate for Payer: Cash Price |
$135.80
|
| Rate for Payer: Central Health Plan Commercial |
$241.42
|
| Rate for Payer: Cigna of CA HMO |
$193.13
|
| Rate for Payer: Cigna of CA PPO |
$223.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.50
|
| Rate for Payer: Dignity Health Media |
$256.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$256.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.59
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$226.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$105.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.35
|
| Rate for Payer: Multiplan Commercial |
$226.33
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
| Rate for Payer: Riverside University Health System MISP |
$120.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.88
|
| Rate for Payer: United Healthcare All Other HMO |
$150.88
|
| Rate for Payer: United Healthcare HMO Rider |
$150.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.50
|
| Rate for Payer: Vantage Medical Group Senior |
$256.50
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
OP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$206.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$187.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$164.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$201.07
|
| Rate for Payer: Blue Distinction Transplant |
$204.20
|
| Rate for Payer: Blue Shield of California Commercial |
$214.07
|
| Rate for Payer: Blue Shield of California EPN |
$166.43
|
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: Cigna of CA HMO |
$217.82
|
| Rate for Payer: Cigna of CA PPO |
$251.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.29
|
| Rate for Payer: Dignity Health Media |
$289.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$289.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$255.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$119.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Multiplan Commercial |
$255.26
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
| Rate for Payer: Riverside University Health System MISP |
$136.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$170.17
|
| Rate for Payer: United Healthcare All Other HMO |
$170.17
|
| Rate for Payer: United Healthcare HMO Rider |
$170.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$170.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$289.29
|
| Rate for Payer: Vantage Medical Group Senior |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
IP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Multiplan Commercial |
$255.26
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
OP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$228.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$207.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$222.73
|
| Rate for Payer: Blue Distinction Transplant |
$226.20
|
| Rate for Payer: Blue Shield of California Commercial |
$237.13
|
| Rate for Payer: Blue Shield of California EPN |
$184.35
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Media |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$282.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$131.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Riverside University Health System MISP |
$150.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
IP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$339.30 |
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Central Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$339.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.40
|
| Rate for Payer: Multiplan Commercial |
$282.75
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
IP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
OP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$284.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$257.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$277.11
|
| Rate for Payer: Blue Distinction Transplant |
$281.42
|
| Rate for Payer: Blue Shield of California Commercial |
$295.03
|
| Rate for Payer: Blue Shield of California EPN |
$229.36
|
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: Central Health Plan Commercial |
$375.23
|
| Rate for Payer: Cigna of CA HMO |
$300.19
|
| Rate for Payer: Cigna of CA PPO |
$347.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$398.68
|
| Rate for Payer: Dignity Health Media |
$398.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$398.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$422.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$351.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$164.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.81
|
| Rate for Payer: Multiplan Commercial |
$351.78
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
| Rate for Payer: Riverside University Health System MISP |
$187.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$281.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.52
|
| Rate for Payer: United Healthcare All Other HMO |
$234.52
|
| Rate for Payer: United Healthcare HMO Rider |
$234.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$398.68
|
| Rate for Payer: Vantage Medical Group Senior |
$398.68
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
OP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,203.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,089.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,089.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$959.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,170.37
|
| Rate for Payer: Blue Distinction Transplant |
$1,188.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,246.05
|
| Rate for Payer: Blue Shield of California EPN |
$968.71
|
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: Cigna of CA HMO |
$1,267.84
|
| Rate for Payer: Cigna of CA PPO |
$1,465.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Dignity Health Media |
$1,683.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,683.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,485.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$693.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
| Rate for Payer: Riverside University Health System MISP |
$792.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.50
|
| Rate for Payer: United Healthcare All Other HMO |
$990.50
|
| Rate for Payer: United Healthcare HMO Rider |
$990.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,683.85
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
IP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,782.90 |
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,584.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,782.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.20
|
| Rate for Payer: Multiplan Commercial |
$1,485.75
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
OP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$4,713.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,880.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,880.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,536.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,094.32
|
| Rate for Payer: Blue Distinction Transplant |
$3,142.50
|
| Rate for Payer: Blue Shield of California Commercial |
$3,294.39
|
| Rate for Payer: Blue Shield of California EPN |
$2,561.14
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| Rate for Payer: Cigna of CA HMO |
$3,352.00
|
| Rate for Payer: Cigna of CA PPO |
$3,875.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Dignity Health Media |
$4,451.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,451.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,713.75
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,928.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,833.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,995.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.50
|
| Rate for Payer: Multiplan Commercial |
$3,928.12
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,142.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,142.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,618.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,618.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,618.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,618.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,451.88
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
IP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.50 |
| Max. Negotiated Rate |
$4,713.75 |
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Central Health Plan Commercial |
$4,190.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,713.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,995.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,047.50
|
| Rate for Payer: Multiplan Commercial |
$3,928.12
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$356.40 |
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Central Health Plan Commercial |
$316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.40
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$356.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.20
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: Networks By Design Commercial |
$257.40
|
| Rate for Payer: Prime Health Services Commercial |
$336.60
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$390.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$336.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$237.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Cash Price |
$178.20
|
| Rate for Payer: Central Health Plan Commercial |
$316.80
|
| Rate for Payer: Cigna of CA PPO |
$293.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$336.60
|
| Rate for Payer: Dignity Health Media |
$336.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$158.40
|
| Rate for Payer: Galaxy Health WC |
$336.60
|
| Rate for Payer: Global Benefits Group Commercial |
$237.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$356.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$297.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$138.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.20
|
| Rate for Payer: Multiplan Commercial |
$297.00
|
| Rate for Payer: Networks By Design Commercial |
$257.40
|
| Rate for Payer: Prime Health Services Commercial |
$336.60
|
| Rate for Payer: Riverside University Health System MISP |
$158.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$237.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.60
|
| Rate for Payer: Vantage Medical Group Senior |
$336.60
|
|
|
HC CATHETER CHAIT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| 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: 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 CATHETER CHAIT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
Hospital Revenue Code
|
272
|
| 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 CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
IP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
OP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.49
|
| Rate for Payer: Blue Distinction Transplant |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$62.27
|
| Rate for Payer: Blue Shield of California EPN |
$48.41
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.15
|
| Rate for Payer: Dignity Health Media |
$84.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$74.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Riverside University Health System MISP |
$39.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.50
|
| Rate for Payer: United Healthcare All Other HMO |
$49.50
|
| Rate for Payer: United Healthcare HMO Rider |
$49.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.15
|
| Rate for Payer: Vantage Medical Group Senior |
$84.15
|
|
