|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
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
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
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 18FR 5-15CC
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
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 18FR 5-15CC
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
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
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Central Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Multiplan Commercial |
$19.12
|
| Rate for Payer: Networks By Design Commercial |
$16.58
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.07
|
| Rate for Payer: Blue Distinction Transplant |
$15.30
|
| Rate for Payer: Blue Shield of California Commercial |
$16.04
|
| Rate for Payer: Blue Shield of California EPN |
$12.47
|
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Central Health Plan Commercial |
$20.40
|
| Rate for Payer: Cigna of CA HMO |
$16.32
|
| Rate for Payer: Cigna of CA PPO |
$18.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.68
|
| Rate for Payer: Dignity Health Media |
$21.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.95
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Multiplan Commercial |
$19.12
|
| Rate for Payer: Networks By Design Commercial |
$16.58
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
| Rate for Payer: Riverside University Health System MISP |
$10.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.75
|
| Rate for Payer: United Healthcare All Other HMO |
$12.75
|
| Rate for Payer: United Healthcare HMO Rider |
$12.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.68
|
| Rate for Payer: Vantage Medical Group Senior |
$21.68
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.17
|
| Rate for Payer: Blue Distinction Transplant |
$15.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Media |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.17
|
| Rate for Payer: Blue Distinction Transplant |
$15.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Media |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
OP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.02
|
| Rate for Payer: Blue Distinction Transplant |
$18.30
|
| Rate for Payer: Blue Shield of California Commercial |
$19.18
|
| Rate for Payer: Blue Shield of California EPN |
$14.91
|
| Rate for Payer: Cash Price |
$13.73
|
| Rate for Payer: Cash Price |
$13.73
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.92
|
| Rate for Payer: Dignity Health Media |
$25.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.92
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.92
|
| Rate for Payer: Riverside University Health System MISP |
$12.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.92
|
| Rate for Payer: Vantage Medical Group Senior |
$25.92
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
IP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Cash Price |
$13.73
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.92
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.92
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
IP
|
$14.02
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.62 |
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Central Health Plan Commercial |
$11.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.61
|
| Rate for Payer: Galaxy Health WC |
$11.92
|
| Rate for Payer: Global Benefits Group Commercial |
$8.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.52
|
| Rate for Payer: Networks By Design Commercial |
$9.11
|
| Rate for Payer: Prime Health Services Commercial |
$11.92
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
OP
|
$14.02
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$51.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.28
|
| Rate for Payer: Blue Distinction Transplant |
$8.41
|
| Rate for Payer: Blue Shield of California Commercial |
$8.82
|
| Rate for Payer: Blue Shield of California EPN |
$6.86
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Central Health Plan Commercial |
$11.22
|
| Rate for Payer: Cigna of CA HMO |
$8.97
|
| Rate for Payer: Cigna of CA PPO |
$10.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.92
|
| Rate for Payer: Dignity Health Media |
$11.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.61
|
| Rate for Payer: Galaxy Health WC |
$11.92
|
| Rate for Payer: Global Benefits Group Commercial |
$8.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.52
|
| Rate for Payer: Networks By Design Commercial |
$9.11
|
| Rate for Payer: Prime Health Services Commercial |
$11.92
|
| Rate for Payer: Riverside University Health System MISP |
$5.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.92
|
| Rate for Payer: Vantage Medical Group Senior |
$11.92
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
OP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.96
|
| Rate for Payer: Blue Distinction Transplant |
$66.98
|
| Rate for Payer: Blue Shield of California Commercial |
$70.22
|
| Rate for Payer: Blue Shield of California EPN |
$54.59
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Central Health Plan Commercial |
$89.31
|
| Rate for Payer: Cigna of CA HMO |
$71.45
|
| Rate for Payer: Cigna of CA PPO |
$82.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.89
|
| Rate for Payer: Dignity Health Media |
$94.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.48
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$83.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Multiplan Commercial |
$83.73
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
| Rate for Payer: Riverside University Health System MISP |
$44.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.82
|
| Rate for Payer: United Healthcare All Other HMO |
$55.82
|
| Rate for Payer: United Healthcare HMO Rider |
$55.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.89
|
| Rate for Payer: Vantage Medical Group Senior |
$94.89
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
IP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Central Health Plan Commercial |
$89.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Multiplan Commercial |
$83.73
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.17
|
| Rate for Payer: Blue Distinction Transplant |
$15.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Media |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
IP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Central Health Plan Commercial |
$42.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.61
|
| Rate for Payer: Multiplan Commercial |
$39.79
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
OP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.34
|
| Rate for Payer: Blue Distinction Transplant |
$31.83
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$25.94
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Central Health Plan Commercial |
$42.44
|
| Rate for Payer: Cigna of CA HMO |
$33.95
|
| Rate for Payer: Cigna of CA PPO |
$39.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.09
|
| Rate for Payer: Dignity Health Media |
$45.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.74
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.61
|
| Rate for Payer: Multiplan Commercial |
$39.79
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
| Rate for Payer: Riverside University Health System MISP |
$21.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.52
|
| Rate for Payer: United Healthcare All Other HMO |
$26.52
|
| Rate for Payer: United Healthcare HMO Rider |
$26.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.09
|
| Rate for Payer: Vantage Medical Group Senior |
$45.09
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.17
|
| Rate for Payer: Blue Distinction Transplant |
$15.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Media |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
OP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.92
|
| Rate for Payer: Blue Distinction Transplant |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.84
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Media |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Riverside University Health System MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
IP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.17
|
| Rate for Payer: Blue Distinction Transplant |
$15.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$20.54
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Media |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$19.25
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Riverside University Health System MISP |
$10.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
