|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
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 22FR 2WY 30C
|
Facility
|
OP
|
$29.85
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.64
|
| Rate for Payer: Blue Distinction Transplant |
$17.91
|
| Rate for Payer: Blue Shield of California Commercial |
$18.78
|
| Rate for Payer: Blue Shield of California EPN |
$14.60
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: Cigna of CA HMO |
$19.10
|
| Rate for Payer: Cigna of CA PPO |
$22.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.37
|
| Rate for Payer: Dignity Health Media |
$25.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
| Rate for Payer: Riverside University Health System MISP |
$11.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.92
|
| Rate for Payer: United Healthcare All Other HMO |
$14.92
|
| Rate for Payer: United Healthcare HMO Rider |
$14.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.37
|
| Rate for Payer: Vantage Medical Group Senior |
$25.37
|
|
|
HC CATH FOLEY SLCN 22FR 2WY 30C
|
Facility
|
IP
|
$29.85
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$26.86 |
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Central Health Plan Commercial |
$23.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.39
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
IP
|
$40.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$36.46 |
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Central Health Plan Commercial |
$32.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.20
|
| Rate for Payer: Galaxy Health WC |
$34.43
|
| Rate for Payer: Global Benefits Group Commercial |
$24.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.10
|
| Rate for Payer: Multiplan Commercial |
$30.38
|
| Rate for Payer: Networks By Design Commercial |
$26.33
|
| Rate for Payer: Prime Health Services Commercial |
$34.43
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
OP
|
$40.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.93
|
| Rate for Payer: Blue Distinction Transplant |
$24.31
|
| Rate for Payer: Blue Shield of California Commercial |
$25.48
|
| Rate for Payer: Blue Shield of California EPN |
$19.81
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Central Health Plan Commercial |
$32.41
|
| Rate for Payer: Cigna of CA HMO |
$25.93
|
| Rate for Payer: Cigna of CA PPO |
$29.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.43
|
| Rate for Payer: Dignity Health Media |
$34.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.20
|
| Rate for Payer: Galaxy Health WC |
$34.43
|
| Rate for Payer: Global Benefits Group Commercial |
$24.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.10
|
| Rate for Payer: Multiplan Commercial |
$30.38
|
| Rate for Payer: Networks By Design Commercial |
$26.33
|
| Rate for Payer: Prime Health Services Commercial |
$34.43
|
| Rate for Payer: Riverside University Health System MISP |
$16.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.26
|
| Rate for Payer: United Healthcare All Other HMO |
$20.26
|
| Rate for Payer: United Healthcare HMO Rider |
$20.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.43
|
| Rate for Payer: Vantage Medical Group Senior |
$34.43
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
OP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.09
|
| Rate for Payer: Blue Distinction Transplant |
$19.39
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$15.80
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Central Health Plan Commercial |
$25.85
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$23.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.46
|
| Rate for Payer: Dignity Health Media |
$27.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.08
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$24.23
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
| Rate for Payer: Riverside University Health System MISP |
$12.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.16
|
| Rate for Payer: United Healthcare All Other HMO |
$16.16
|
| Rate for Payer: United Healthcare HMO Rider |
$16.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.46
|
| Rate for Payer: Vantage Medical Group Senior |
$27.46
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
IP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$29.08 |
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Central Health Plan Commercial |
$25.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$24.23
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.03 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$642.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$642.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$565.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$690.29
|
| Rate for Payer: Blue Distinction Transplant |
$701.04
|
| Rate for Payer: Blue Shield of California Commercial |
$734.92
|
| Rate for Payer: Blue Shield of California EPN |
$571.35
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$747.78
|
| Rate for Payer: Cigna of CA PPO |
$864.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$993.14
|
| Rate for Payer: Dignity Health Media |
$993.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$993.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$876.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$759.46
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: Riverside University Health System MISP |
$467.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$701.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$701.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$584.20
|
| Rate for Payer: United Healthcare All Other HMO |
$584.20
|
| Rate for Payer: United Healthcare HMO Rider |
$584.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$584.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$993.14
|
| Rate for Payer: Vantage Medical Group Senior |
$993.14
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$759.46
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
OP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.97
|
| Rate for Payer: Blue Distinction Transplant |
$18.25
|
| Rate for Payer: Blue Shield of California Commercial |
$19.13
|
| Rate for Payer: Blue Shield of California EPN |
$14.88
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Central Health Plan Commercial |
$24.34
|
| Rate for Payer: Cigna of CA HMO |
$19.47
|
| Rate for Payer: Cigna of CA PPO |
$22.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.86
|
| Rate for Payer: Dignity Health Media |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Riverside University Health System MISP |
$12.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.21
|
| Rate for Payer: United Healthcare All Other HMO |
$15.21
|
| Rate for Payer: United Healthcare HMO Rider |
$15.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.86
|
| Rate for Payer: Vantage Medical Group Senior |
$25.86
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
IP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$27.38 |
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Central Health Plan Commercial |
$24.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
OP
|
$127.38
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$114.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$108.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$70.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.26
|
| Rate for Payer: Blue Distinction Transplant |
$76.43
|
| Rate for Payer: Blue Shield of California Commercial |
$80.12
|
| Rate for Payer: Blue Shield of California EPN |
$62.29
|
| Rate for Payer: Cash Price |
$57.32
|
| Rate for Payer: Cash Price |
$57.32
|
| Rate for Payer: Central Health Plan Commercial |
$101.90
|
| Rate for Payer: Cigna of CA HMO |
$81.52
|
| Rate for Payer: Cigna of CA PPO |
$94.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$108.27
|
| Rate for Payer: Dignity Health Media |
$108.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.95
|
| Rate for Payer: Galaxy Health WC |
$108.27
|
| Rate for Payer: Global Benefits Group Commercial |
$76.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.64
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$95.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.48
|
| Rate for Payer: Multiplan Commercial |
$95.54
|
| Rate for Payer: Networks By Design Commercial |
$82.80
|
| Rate for Payer: Prime Health Services Commercial |
$108.27
|
| Rate for Payer: Riverside University Health System MISP |
$50.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.69
|
| Rate for Payer: United Healthcare All Other HMO |
$63.69
|
| Rate for Payer: United Healthcare HMO Rider |
$63.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.27
|
| Rate for Payer: Vantage Medical Group Senior |
$108.27
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
IP
|
$127.38
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$114.64 |
| Rate for Payer: Cash Price |
$57.32
|
| Rate for Payer: Central Health Plan Commercial |
$101.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.95
|
| Rate for Payer: Galaxy Health WC |
$108.27
|
| Rate for Payer: Global Benefits Group Commercial |
$76.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.48
|
| Rate for Payer: Multiplan Commercial |
$95.54
|
| Rate for Payer: Networks By Design Commercial |
$82.80
|
| Rate for Payer: Prime Health Services Commercial |
$108.27
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.67
|
| Rate for Payer: Blue Distinction Transplant |
$19.97
|
| Rate for Payer: Blue Shield of California Commercial |
$20.94
|
| Rate for Payer: Blue Shield of California EPN |
$16.28
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Central Health Plan Commercial |
$26.63
|
| Rate for Payer: Cigna of CA HMO |
$21.31
|
| Rate for Payer: Cigna of CA PPO |
$24.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.30
|
| Rate for Payer: Dignity Health Media |
$28.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.96
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$24.97
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
| Rate for Payer: Riverside University Health System MISP |
$13.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.64
|
| Rate for Payer: United Healthcare All Other HMO |
$16.64
|
| Rate for Payer: United Healthcare HMO Rider |
$16.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.30
|
| Rate for Payer: Vantage Medical Group Senior |
$28.30
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
IP
|
$596.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$537.21 |
| Rate for Payer: Blue Shield of California EPN |
$318.74
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Central Health Plan Commercial |
$477.52
|
| Rate for Payer: Cigna of CA HMO |
$417.83
|
| Rate for Payer: Cigna of CA PPO |
$417.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$238.76
|
| Rate for Payer: Galaxy Health WC |
$507.36
|
| Rate for Payer: Global Benefits Group Commercial |
$358.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$537.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.38
|
| Rate for Payer: Multiplan Commercial |
$447.68
|
| Rate for Payer: Prime Health Services Commercial |
$507.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.39
|
| Rate for Payer: United Healthcare All Other HMO |
$220.14
|
| Rate for Payer: United Healthcare HMO Rider |
$215.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.98
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
OP
|
$596.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$537.21 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$507.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$328.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$272.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$332.47
|
| Rate for Payer: Blue Distinction Transplant |
$358.14
|
| Rate for Payer: Blue Shield of California Commercial |
$447.68
|
| Rate for Payer: Blue Shield of California EPN |
$324.71
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Central Health Plan Commercial |
$477.52
|
| Rate for Payer: Cigna of CA HMO |
$417.83
|
| Rate for Payer: Cigna of CA PPO |
$417.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$507.36
|
| Rate for Payer: Dignity Health Media |
$507.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$238.76
|
| Rate for Payer: Galaxy Health WC |
$507.36
|
| Rate for Payer: Global Benefits Group Commercial |
$358.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$537.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$447.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$208.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.38
|
| Rate for Payer: Multiplan Commercial |
$447.68
|
| Rate for Payer: Networks By Design Commercial |
$298.45
|
| Rate for Payer: Prime Health Services Commercial |
$507.36
|
| Rate for Payer: Riverside University Health System MISP |
$238.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$298.45
|
| Rate for Payer: United Healthcare All Other HMO |
$298.45
|
| Rate for Payer: United Healthcare HMO Rider |
$298.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$298.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.36
|
| Rate for Payer: Vantage Medical Group Senior |
$507.36
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,082.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,472.64
|
| Rate for Payer: United Healthcare All Other HMO |
$1,438.32
|
| Rate for Payer: United Healthcare HMO Rider |
$1,407.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,287.00
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,172.30
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,925.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,121.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Media |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,925.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
IP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$584.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$514.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$627.43
|
| Rate for Payer: Blue Distinction Transplant |
$637.20
|
| Rate for Payer: Blue Shield of California Commercial |
$668.00
|
| Rate for Payer: Blue Shield of California EPN |
$519.32
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: Cigna of CA HMO |
$679.68
|
| Rate for Payer: Cigna of CA PPO |
$785.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.70
|
| Rate for Payer: Dignity Health Media |
$902.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$796.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$371.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
| Rate for Payer: Riverside University Health System MISP |
$424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.00
|
| Rate for Payer: United Healthcare All Other HMO |
$531.00
|
| Rate for Payer: United Healthcare HMO Rider |
$531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.70
|
| Rate for Payer: Vantage Medical Group Senior |
$902.70
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$265.86
|
| Rate for Payer: Blue Distinction Transplant |
$270.00
|
| Rate for Payer: Blue Shield of California Commercial |
$283.05
|
| Rate for Payer: Blue Shield of California EPN |
$220.05
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Media |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$337.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$157.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Riverside University Health System MISP |
$180.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$265.86
|
| Rate for Payer: Blue Distinction Transplant |
$270.00
|
| Rate for Payer: Blue Shield of California Commercial |
$283.05
|
| Rate for Payer: Blue Shield of California EPN |
$220.05
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Media |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$337.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$157.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Riverside University Health System MISP |
$180.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
