|
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: Alpha Care Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: Dignity Health Media |
$157.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$138.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$64.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.60
|
| 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: Riverside University Health System 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
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
OP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.21 |
| Max. Negotiated Rate |
$186.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.46
|
| Rate for Payer: Blue Distinction Transplant |
$124.36
|
| Rate for Payer: Blue Shield of California Commercial |
$130.37
|
| Rate for Payer: Blue Shield of California EPN |
$101.36
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Central Health Plan Commercial |
$165.82
|
| Rate for Payer: Cigna of CA HMO |
$132.65
|
| Rate for Payer: Cigna of CA PPO |
$153.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$176.18
|
| Rate for Payer: Dignity Health Media |
$176.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.54
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$155.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.45
|
| Rate for Payer: Multiplan Commercial |
$155.45
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
| Rate for Payer: Riverside University Health System MISP |
$82.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.64
|
| Rate for Payer: United Healthcare All Other HMO |
$103.64
|
| Rate for Payer: United Healthcare HMO Rider |
$103.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.18
|
| Rate for Payer: Vantage Medical Group Senior |
$176.18
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
IP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$186.54 |
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Central Health Plan Commercial |
$165.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$186.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.45
|
| Rate for Payer: Multiplan Commercial |
$155.45
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
OP
|
$119.17
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.83 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.41
|
| Rate for Payer: Blue Distinction Transplant |
$71.50
|
| Rate for Payer: Blue Shield of California Commercial |
$74.96
|
| Rate for Payer: Blue Shield of California EPN |
$58.27
|
| Rate for Payer: Cash Price |
$53.63
|
| Rate for Payer: Cash Price |
$53.63
|
| Rate for Payer: Central Health Plan Commercial |
$95.34
|
| Rate for Payer: Cigna of CA HMO |
$76.27
|
| Rate for Payer: Cigna of CA PPO |
$88.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.29
|
| Rate for Payer: Dignity Health Media |
$101.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.67
|
| Rate for Payer: Galaxy Health WC |
$101.29
|
| Rate for Payer: Global Benefits Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$89.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.83
|
| Rate for Payer: Multiplan Commercial |
$89.38
|
| Rate for Payer: Networks By Design Commercial |
$77.46
|
| Rate for Payer: Prime Health Services Commercial |
$101.29
|
| Rate for Payer: Riverside University Health System MISP |
$47.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.58
|
| Rate for Payer: United Healthcare All Other HMO |
$59.58
|
| Rate for Payer: United Healthcare HMO Rider |
$59.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.29
|
| Rate for Payer: Vantage Medical Group Senior |
$101.29
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
IP
|
$119.17
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.83 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Cash Price |
$53.63
|
| Rate for Payer: Central Health Plan Commercial |
$95.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.67
|
| Rate for Payer: Galaxy Health WC |
$101.29
|
| Rate for Payer: Global Benefits Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.83
|
| Rate for Payer: Multiplan Commercial |
$89.38
|
| Rate for Payer: Networks By Design Commercial |
$77.46
|
| Rate for Payer: Prime Health Services Commercial |
$101.29
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
OP
|
$27.06
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$32.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.99
|
| Rate for Payer: Blue Distinction Transplant |
$16.24
|
| Rate for Payer: Blue Shield of California Commercial |
$17.02
|
| Rate for Payer: Blue Shield of California EPN |
$13.23
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$21.65
|
| Rate for Payer: Cigna of CA HMO |
$17.32
|
| Rate for Payer: Cigna of CA PPO |
$20.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.00
|
| Rate for Payer: Dignity Health Media |
$23.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.35
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.41
|
| Rate for Payer: Multiplan Commercial |
$20.30
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
| Rate for Payer: Riverside University Health System MISP |
$10.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.53
|
| Rate for Payer: United Healthcare All Other HMO |
$13.53
|
| Rate for Payer: United Healthcare HMO Rider |
$13.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.00
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
IP
|
$27.06
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$24.35 |
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.41
|
| Rate for Payer: Multiplan Commercial |
$20.30
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
IP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
OP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.35
|
| Rate for Payer: Blue Distinction Transplant |
$57.23
|
| Rate for Payer: Blue Shield of California Commercial |
$59.99
|
| Rate for Payer: Blue Shield of California EPN |
$46.64
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Media |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Riverside University Health System MISP |
$38.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
IP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$16.38 |
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
OP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$32.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.75
|
| Rate for Payer: Blue Distinction Transplant |
$10.92
|
| Rate for Payer: Blue Shield of California Commercial |
$11.45
|
| Rate for Payer: Blue Shield of California EPN |
$8.90
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Central Health Plan Commercial |
$14.56
|
| Rate for Payer: Cigna of CA HMO |
$11.65
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.47
|
| Rate for Payer: Dignity Health Media |
$15.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
| Rate for Payer: Riverside University Health System MISP |
$7.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.10
|
| Rate for Payer: United Healthcare HMO Rider |
$9.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.47
|
| Rate for Payer: Vantage Medical Group Senior |
$15.47
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
OP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.43
|
| Rate for Payer: Blue Distinction Transplant |
$37.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38.78
|
| Rate for Payer: Blue Shield of California EPN |
$30.15
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Media |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Riverside University Health System MISP |
$24.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
IP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
IP
|
$59.45
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
OP
|
$59.45
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.12
|
| Rate for Payer: Blue Distinction Transplant |
$35.67
|
| Rate for Payer: Blue Shield of California Commercial |
$37.39
|
| Rate for Payer: Blue Shield of California EPN |
$29.07
|
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: Cigna of CA HMO |
$38.05
|
| Rate for Payer: Cigna of CA PPO |
$43.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.53
|
| Rate for Payer: Dignity Health Media |
$50.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$44.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
| Rate for Payer: Riverside University Health System MISP |
$23.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.72
|
| Rate for Payer: United Healthcare All Other HMO |
$29.72
|
| Rate for Payer: United Healthcare HMO Rider |
$29.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.53
|
| Rate for Payer: Vantage Medical Group Senior |
$50.53
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
OP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$51.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.23
|
| Rate for Payer: Blue Distinction Transplant |
$33.75
|
| Rate for Payer: Blue Shield of California Commercial |
$35.38
|
| Rate for Payer: Blue Shield of California EPN |
$27.51
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Central Health Plan Commercial |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$36.00
|
| Rate for Payer: Cigna of CA PPO |
$41.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.81
|
| Rate for Payer: Dignity Health Media |
$47.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$42.19
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
| Rate for Payer: Riverside University Health System MISP |
$22.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.12
|
| Rate for Payer: United Healthcare All Other HMO |
$28.12
|
| Rate for Payer: United Healthcare HMO Rider |
$28.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.81
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
IP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Central Health Plan Commercial |
$45.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$42.19
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
OP
|
$59.45
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.12
|
| Rate for Payer: Blue Distinction Transplant |
$35.67
|
| Rate for Payer: Blue Shield of California Commercial |
$37.39
|
| Rate for Payer: Blue Shield of California EPN |
$29.07
|
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: Cigna of CA HMO |
$38.05
|
| Rate for Payer: Cigna of CA PPO |
$43.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.53
|
| Rate for Payer: Dignity Health Media |
$50.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$44.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
| Rate for Payer: Riverside University Health System MISP |
$23.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.72
|
| Rate for Payer: United Healthcare All Other HMO |
$29.72
|
| Rate for Payer: United Healthcare HMO Rider |
$29.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.53
|
| Rate for Payer: Vantage Medical Group Senior |
$50.53
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
IP
|
$59.45
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
IP
|
$2,212.46
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$442.49 |
| Max. Negotiated Rate |
$1,991.21 |
| Rate for Payer: Cash Price |
$995.61
|
| Rate for Payer: Central Health Plan Commercial |
$1,769.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$884.98
|
| Rate for Payer: Galaxy Health WC |
$1,880.59
|
| Rate for Payer: Global Benefits Group Commercial |
$1,327.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,991.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,475.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$842.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.49
|
| Rate for Payer: Multiplan Commercial |
$1,659.34
|
| Rate for Payer: Networks By Design Commercial |
$1,438.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,880.59
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
OP
|
$2,212.46
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.03 |
| Max. Negotiated Rate |
$1,991.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,880.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,216.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,216.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,071.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,307.12
|
| Rate for Payer: Blue Distinction Transplant |
$1,327.48
|
| Rate for Payer: Blue Shield of California Commercial |
$1,391.64
|
| Rate for Payer: Blue Shield of California EPN |
$1,081.89
|
| Rate for Payer: Cash Price |
$995.61
|
| Rate for Payer: Cash Price |
$995.61
|
| Rate for Payer: Central Health Plan Commercial |
$1,769.97
|
| Rate for Payer: Cigna of CA HMO |
$1,415.97
|
| Rate for Payer: Cigna of CA PPO |
$1,637.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,880.59
|
| Rate for Payer: Dignity Health Media |
$1,880.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,880.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$884.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$884.98
|
| Rate for Payer: Galaxy Health WC |
$1,880.59
|
| Rate for Payer: Global Benefits Group Commercial |
$1,327.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,991.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,659.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$774.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,475.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$842.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.49
|
| Rate for Payer: Multiplan Commercial |
$1,659.34
|
| Rate for Payer: Networks By Design Commercial |
$1,438.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,880.59
|
| Rate for Payer: Riverside University Health System MISP |
$884.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,327.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,327.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,106.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,106.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1,106.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,106.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,880.59
|
| Rate for Payer: Vantage Medical Group Senior |
$1,880.59
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.75
|
| Rate for Payer: Blue Distinction Transplant |
$22.09
|
| Rate for Payer: Blue Shield of California Commercial |
$23.16
|
| Rate for Payer: Blue Shield of California EPN |
$18.00
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Central Health Plan Commercial |
$29.46
|
| Rate for Payer: Cigna of CA HMO |
$23.56
|
| Rate for Payer: Cigna of CA PPO |
$27.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.30
|
| Rate for Payer: Dignity Health Media |
$31.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.36
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
| Rate for Payer: Riverside University Health System MISP |
$14.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.41
|
| Rate for Payer: United Healthcare All Other HMO |
$18.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.30
|
| Rate for Payer: Vantage Medical Group Senior |
$31.30
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Central Health Plan Commercial |
$29.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.36
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.40
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.31
|
| Rate for Payer: Blue Distinction Transplant |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$19.50
|
| Rate for Payer: Blue Shield of California EPN |
$15.16
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.80
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.35
|
| Rate for Payer: Dignity Health Media |
$26.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.40
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Riverside University Health System MISP |
$12.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.50
|
| Rate for Payer: United Healthcare All Other HMO |
$15.50
|
| Rate for Payer: United Healthcare HMO Rider |
$15.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.35
|
| Rate for Payer: Vantage Medical Group Senior |
$26.35
|
|
