|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
OP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$85.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$85.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.34
|
| Rate for Payer: BCBS Transplant Transplant |
$93.00
|
| Rate for Payer: Blue Shield of California Commercial |
$116.25
|
| Rate for Payer: Blue Shield of California EPN |
$84.32
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$131.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$116.25
|
| Rate for Payer: IEHP medi-cal |
$54.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: Riverside University Health MISP |
$62.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$77.50
|
| Rate for Payer: United Healthcare All Other HMO |
$77.50
|
| Rate for Payer: United Healthcare HMO Rider |
$77.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$131.75
|
| Rate for Payer: Vantage Medical Group Senior |
$131.75
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
IP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Blue Shield of California EPN |
$82.77
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Central Health Plan Commercial |
$124.00
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.00
|
| Rate for Payer: Multiplan Commercial |
$116.25
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
|
|
HC CATHETER/GUIDING
|
Facility
IP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC CATHETER/GUIDING
|
Facility
OP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$99.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.34
|
| Rate for Payer: BCBS Transplant Transplant |
$108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$113.22
|
| Rate for Payer: Blue Shield of California EPN |
$88.02
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$115.20
|
| Rate for Payer: Cigna of CA PPO |
$133.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$135.00
|
| Rate for Payer: IEHP medi-cal |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: Riverside University Health MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
IP
|
$171.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.20 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Central Health Plan Commercial |
$136.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.40
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.20
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
OP
|
$171.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.03
|
| Rate for Payer: BCBS Transplant Transplant |
$102.60
|
| Rate for Payer: Blue Shield of California Commercial |
$105.68
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Caremore Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Central Health Plan Commercial |
$136.80
|
| Rate for Payer: Cigna of CA HMO |
$109.44
|
| Rate for Payer: Cigna of CA PPO |
$126.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.57
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$128.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.05
|
| Rate for Payer: IEHP medi-cal |
$14.14
|
| Rate for Payer: IEHP Medicare Advantage |
$8.57
|
| Rate for Payer: Innovage PACE Commercial |
$12.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.48
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
| Rate for Payer: Prime Health Services Medicare |
$9.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$102.60
|
| Rate for Payer: Riverside University Health MISP |
$9.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.57
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
IP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,439.45 |
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.92
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.82
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.92
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
OP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,303.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,490.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,490.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,312.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,601.36
|
| Rate for Payer: BCBS Transplant Transplant |
$1,626.30
|
| Rate for Payer: Blue Shield of California Commercial |
$1,704.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,325.43
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,168.40
|
| Rate for Payer: Cigna of CA HMO |
$1,734.72
|
| Rate for Payer: Cigna of CA PPO |
$2,005.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,303.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.92
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,439.45
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,032.88
|
| Rate for Payer: IEHP medi-cal |
$948.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.10
|
| Rate for Payer: Multiplan Commercial |
$2,032.88
|
| Rate for Payer: Networks By Design Commercial |
$1,761.82
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,626.30
|
| Rate for Payer: Riverside University Health MISP |
$1,084.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,626.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,626.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,355.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,355.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,355.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,355.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,303.92
|
| Rate for Payer: Vantage Medical Group Senior |
$2,303.92
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
IP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
OP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$2,679.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,679.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$796.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$796.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$701.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$856.07
|
| Rate for Payer: BCBS Transplant Transplant |
$869.40
|
| Rate for Payer: Blue Shield of California Commercial |
$911.42
|
| Rate for Payer: Blue Shield of California EPN |
$708.56
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,231.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,086.75
|
| Rate for Payer: IEHP medi-cal |
$507.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: Riverside University Health MISP |
$579.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$724.50
|
| Rate for Payer: United Healthcare All Other HMO |
$724.50
|
| Rate for Payer: United Healthcare HMO Rider |
$724.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,231.65
|
|
|
HC CATHETER PIONEER
|
Facility
IP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
|
|
HC CATHETER PIONEER
|
Facility
OP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$7,188.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,450.65
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,393.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,393.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,867.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,719.02
|
| Rate for Payer: BCBS Transplant Transplant |
$4,792.50
|
| Rate for Payer: Blue Shield of California Commercial |
$5,024.14
|
| Rate for Payer: Blue Shield of California EPN |
$3,905.89
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Central Health Plan Commercial |
$6,390.00
|
| Rate for Payer: Cigna of CA HMO |
$5,112.00
|
| Rate for Payer: Cigna of CA PPO |
$5,910.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,789.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.75
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,990.62
|
| Rate for Payer: IEHP medi-cal |
$2,795.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.50
|
| Rate for Payer: Multiplan Commercial |
$5,990.62
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,792.50
|
| Rate for Payer: Riverside University Health MISP |
$3,195.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,792.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,792.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,993.75
|
| Rate for Payer: United Healthcare All Other HMO |
$3,993.75
|
| Rate for Payer: United Healthcare HMO Rider |
$3,993.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,993.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Senior |
$6,789.38
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
IP
|
$101.61
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$91.45 |
| Rate for Payer: Cash Price |
$45.72
|
| Rate for Payer: Central Health Plan Commercial |
$81.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.64
|
| Rate for Payer: Galaxy Health WC |
$86.37
|
| Rate for Payer: Global Benefits Group Commercial |
$60.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.32
|
| Rate for Payer: Multiplan Commercial |
$76.21
|
| Rate for Payer: Networks By Design Commercial |
$66.05
|
| Rate for Payer: Prime Health Services Commercial |
$86.37
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
OP
|
$101.61
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$91.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$86.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$55.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$55.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.03
|
| Rate for Payer: BCBS Transplant Transplant |
$60.97
|
| Rate for Payer: Blue Shield of California Commercial |
$63.91
|
| Rate for Payer: Blue Shield of California EPN |
$49.69
|
| Rate for Payer: Cash Price |
$45.72
|
| Rate for Payer: Central Health Plan Commercial |
$81.29
|
| Rate for Payer: Cigna of CA HMO |
$65.03
|
| Rate for Payer: Cigna of CA PPO |
$75.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.64
|
| Rate for Payer: Galaxy Health WC |
$86.37
|
| Rate for Payer: Global Benefits Group Commercial |
$60.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.45
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$76.21
|
| Rate for Payer: IEHP medi-cal |
$35.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.32
|
| Rate for Payer: Multiplan Commercial |
$76.21
|
| Rate for Payer: Networks By Design Commercial |
$66.05
|
| Rate for Payer: Prime Health Services Commercial |
$86.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$60.97
|
| Rate for Payer: Riverside University Health MISP |
$40.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.80
|
| Rate for Payer: United Healthcare All Other HMO |
$50.80
|
| Rate for Payer: United Healthcare HMO Rider |
$50.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.37
|
| Rate for Payer: Vantage Medical Group Senior |
$86.37
|
|
|
HC CATH FOGARTY 10FR
|
Facility
OP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$376.97
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$376.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$331.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$404.93
|
| Rate for Payer: BCBS Transplant Transplant |
$411.24
|
| Rate for Payer: Blue Shield of California Commercial |
$431.12
|
| Rate for Payer: Blue Shield of California EPN |
$335.16
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: Cigna of CA HMO |
$438.66
|
| Rate for Payer: Cigna of CA PPO |
$507.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$582.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$514.05
|
| Rate for Payer: IEHP medi-cal |
$239.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$411.24
|
| Rate for Payer: Riverside University Health MISP |
$274.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$411.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$411.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.70
|
| Rate for Payer: United Healthcare All Other HMO |
$342.70
|
| Rate for Payer: United Healthcare HMO Rider |
$342.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$582.59
|
| Rate for Payer: Vantage Medical Group Senior |
$582.59
|
|
|
HC CATH FOGARTY 10FR
|
Facility
IP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$616.86 |
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Central Health Plan Commercial |
$548.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$616.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.08
|
| Rate for Payer: Multiplan Commercial |
$514.05
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
OP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$339.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$339.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$298.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.17
|
| Rate for Payer: BCBS Transplant Transplant |
$369.84
|
| Rate for Payer: Blue Shield of California Commercial |
$387.72
|
| Rate for Payer: Blue Shield of California EPN |
$301.42
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: Cigna of CA HMO |
$394.50
|
| Rate for Payer: Cigna of CA PPO |
$456.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$523.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$462.30
|
| Rate for Payer: IEHP medi-cal |
$215.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$369.84
|
| Rate for Payer: Riverside University Health MISP |
$246.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$369.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$308.20
|
| Rate for Payer: United Healthcare All Other HMO |
$308.20
|
| Rate for Payer: United Healthcare HMO Rider |
$308.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$523.94
|
| Rate for Payer: Vantage Medical Group Senior |
$523.94
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
IP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$554.76 |
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Central Health Plan Commercial |
$493.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.28
|
| Rate for Payer: Multiplan Commercial |
$462.30
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
OP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$83.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.03
|
| Rate for Payer: BCBS Transplant Transplant |
$16.28
|
| Rate for Payer: Blue Shield of California Commercial |
$17.07
|
| Rate for Payer: Blue Shield of California EPN |
$13.27
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: Cigna of CA HMO |
$17.37
|
| Rate for Payer: Cigna of CA PPO |
$20.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.36
|
| Rate for Payer: IEHP medi-cal |
$9.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.28
|
| Rate for Payer: Riverside University Health MISP |
$10.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.57
|
| Rate for Payer: United Healthcare All Other HMO |
$13.57
|
| Rate for Payer: United Healthcare HMO Rider |
$13.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.07
|
| Rate for Payer: Vantage Medical Group Senior |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
IP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$24.43 |
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Central Health Plan Commercial |
$21.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
| Rate for Payer: Multiplan Commercial |
$20.36
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
OP
|
$103.66
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$93.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$88.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$57.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$57.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.24
|
| Rate for Payer: BCBS Transplant Transplant |
$62.20
|
| Rate for Payer: Blue Shield of California Commercial |
$65.20
|
| Rate for Payer: Blue Shield of California EPN |
$50.69
|
| Rate for Payer: Cash Price |
$46.65
|
| Rate for Payer: Cash Price |
$46.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.93
|
| Rate for Payer: Cigna of CA HMO |
$66.34
|
| Rate for Payer: Cigna of CA PPO |
$76.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$88.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.46
|
| Rate for Payer: Galaxy Health WC |
$88.11
|
| Rate for Payer: Global Benefits Group Commercial |
$62.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$77.74
|
| Rate for Payer: IEHP medi-cal |
$36.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.73
|
| Rate for Payer: Multiplan Commercial |
$77.74
|
| Rate for Payer: Networks By Design Commercial |
$67.38
|
| Rate for Payer: Prime Health Services Commercial |
$88.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$62.20
|
| Rate for Payer: Riverside University Health MISP |
$41.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.83
|
| Rate for Payer: United Healthcare All Other HMO |
$51.83
|
| Rate for Payer: United Healthcare HMO Rider |
$51.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$88.11
|
| Rate for Payer: Vantage Medical Group Senior |
$88.11
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
IP
|
$103.66
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$93.29 |
| Rate for Payer: Cash Price |
$46.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.46
|
| Rate for Payer: Galaxy Health WC |
$88.11
|
| Rate for Payer: Global Benefits Group Commercial |
$62.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.73
|
| Rate for Payer: Multiplan Commercial |
$77.74
|
| Rate for Payer: Networks By Design Commercial |
$67.38
|
| Rate for Payer: Prime Health Services Commercial |
$88.11
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
OP
|
$82.00
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.45
|
| Rate for Payer: BCBS Transplant Transplant |
$49.20
|
| Rate for Payer: Blue Shield of California Commercial |
$51.58
|
| Rate for Payer: Blue Shield of California EPN |
$40.10
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61.50
|
| Rate for Payer: IEHP medi-cal |
$28.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: Riverside University Health MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
IP
|
$82.00
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
OP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.21 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$101.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$89.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.47
|
| Rate for Payer: BCBS Transplant Transplant |
$111.17
|
| Rate for Payer: Blue Shield of California Commercial |
$116.55
|
| Rate for Payer: Blue Shield of California EPN |
$90.61
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$118.59
|
| Rate for Payer: Cigna of CA PPO |
$137.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$138.97
|
| Rate for Payer: IEHP medi-cal |
$64.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: Riverside University Health MISP |
$74.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
