|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
IP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$19.33 |
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Central Health Plan Commercial |
$17.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.30
|
| Rate for Payer: Multiplan Commercial |
$16.11
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
IP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$31.07 |
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Central Health Plan Commercial |
$27.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.90
|
| Rate for Payer: Multiplan Commercial |
$25.89
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
OP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.39
|
| Rate for Payer: Blue Distinction Transplant |
$20.71
|
| Rate for Payer: Blue Shield of California Commercial |
$21.71
|
| Rate for Payer: Blue Shield of California EPN |
$16.88
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Central Health Plan Commercial |
$27.62
|
| Rate for Payer: Cigna of CA HMO |
$22.09
|
| Rate for Payer: Cigna of CA PPO |
$25.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.34
|
| Rate for Payer: Dignity Health Media |
$29.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.90
|
| Rate for Payer: Multiplan Commercial |
$25.89
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
| Rate for Payer: Riverside University Health System MISP |
$13.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.26
|
| Rate for Payer: United Healthcare All Other HMO |
$17.26
|
| Rate for Payer: United Healthcare HMO Rider |
$17.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.34
|
| Rate for Payer: Vantage Medical Group Senior |
$29.34
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
OP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,190.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,984.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,984.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,746.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,131.31
|
| Rate for Payer: Blue Distinction Transplant |
$2,164.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,269.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,764.07
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: Cigna of CA HMO |
$2,308.80
|
| Rate for Payer: Cigna of CA PPO |
$2,669.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Dignity Health Media |
$3,066.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,066.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,705.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,262.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
| Rate for Payer: Riverside University Health System MISP |
$1,443.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,164.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,164.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,803.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,803.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,803.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,803.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Senior |
$3,066.38
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
IP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,246.75 |
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,886.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,246.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$721.50
|
| Rate for Payer: Multiplan Commercial |
$2,705.62
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
OP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,091.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,841.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,246.52
|
| Rate for Payer: Blue Distinction Transplant |
$2,281.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,391.77
|
| Rate for Payer: Blue Shield of California EPN |
$1,859.42
|
| Rate for Payer: Cash Price |
$1,711.13
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: Cigna of CA HMO |
$2,433.60
|
| Rate for Payer: Cigna of CA PPO |
$2,813.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Dignity Health Media |
$3,232.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,851.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,330.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
| Rate for Payer: Riverside University Health System MISP |
$1,521.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.12
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
IP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,422.25 |
| Rate for Payer: Cash Price |
$1,711.13
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.50
|
| Rate for Payer: Multiplan Commercial |
$2,851.88
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
|
|
HC CATH INDIGO THROM
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Blue Shield of California EPN |
$2,603.25
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,840.80
|
| Rate for Payer: United Healthcare All Other HMO |
$1,797.90
|
| Rate for Payer: United Healthcare HMO Rider |
$1,758.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,608.75
|
|
|
HC CATH INDIGO THROM
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,681.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,225.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,715.38
|
| Rate for Payer: Blue Distinction Transplant |
$2,925.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,656.25
|
| Rate for Payer: Blue Shield of California EPN |
$2,652.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Media |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,656.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,706.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
OP
|
$76.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$68.56 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.43
|
| Rate for Payer: Blue Distinction Transplant |
$45.71
|
| Rate for Payer: Blue Shield of California Commercial |
$57.14
|
| Rate for Payer: Blue Shield of California EPN |
$41.44
|
| Rate for Payer: Cash Price |
$34.28
|
| Rate for Payer: Central Health Plan Commercial |
$60.94
|
| Rate for Payer: Cigna of CA HMO |
$53.33
|
| Rate for Payer: Cigna of CA PPO |
$53.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.75
|
| Rate for Payer: Dignity Health Media |
$64.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.47
|
| Rate for Payer: Galaxy Health WC |
$64.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$57.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.24
|
| Rate for Payer: Multiplan Commercial |
$57.14
|
| Rate for Payer: Networks By Design Commercial |
$38.09
|
| Rate for Payer: Prime Health Services Commercial |
$64.75
|
| Rate for Payer: Riverside University Health System MISP |
$30.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.09
|
| Rate for Payer: United Healthcare All Other HMO |
$38.09
|
| Rate for Payer: United Healthcare HMO Rider |
$38.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.75
|
| Rate for Payer: Vantage Medical Group Senior |
$64.75
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
IP
|
$76.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$68.56 |
| Rate for Payer: Blue Shield of California EPN |
$40.68
|
| Rate for Payer: Cash Price |
$34.28
|
| Rate for Payer: Central Health Plan Commercial |
$60.94
|
| Rate for Payer: Cigna of CA HMO |
$53.33
|
| Rate for Payer: Cigna of CA PPO |
$53.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.47
|
| Rate for Payer: Galaxy Health WC |
$64.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.24
|
| Rate for Payer: Multiplan Commercial |
$57.14
|
| Rate for Payer: Prime Health Services Commercial |
$64.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.77
|
| Rate for Payer: United Healthcare All Other HMO |
$28.10
|
| Rate for Payer: United Healthcare HMO Rider |
$27.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.14
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
IP
|
$96.82
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$87.14 |
| Rate for Payer: Cash Price |
$43.57
|
| Rate for Payer: Central Health Plan Commercial |
$77.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.73
|
| Rate for Payer: Galaxy Health WC |
$82.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.36
|
| Rate for Payer: Multiplan Commercial |
$72.62
|
| Rate for Payer: Networks By Design Commercial |
$62.93
|
| Rate for Payer: Prime Health Services Commercial |
$82.30
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
OP
|
$96.82
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$87.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.20
|
| Rate for Payer: Blue Distinction Transplant |
$58.09
|
| Rate for Payer: Blue Shield of California Commercial |
$60.90
|
| Rate for Payer: Blue Shield of California EPN |
$47.34
|
| Rate for Payer: Cash Price |
$43.57
|
| Rate for Payer: Central Health Plan Commercial |
$77.46
|
| Rate for Payer: Cigna of CA HMO |
$61.96
|
| Rate for Payer: Cigna of CA PPO |
$71.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.30
|
| Rate for Payer: Dignity Health Media |
$82.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.73
|
| Rate for Payer: Galaxy Health WC |
$82.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$72.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.36
|
| Rate for Payer: Multiplan Commercial |
$72.62
|
| Rate for Payer: Networks By Design Commercial |
$62.93
|
| Rate for Payer: Prime Health Services Commercial |
$82.30
|
| Rate for Payer: Riverside University Health System MISP |
$38.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.41
|
| Rate for Payer: United Healthcare All Other HMO |
$48.41
|
| Rate for Payer: United Healthcare HMO Rider |
$48.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.30
|
| Rate for Payer: Vantage Medical Group Senior |
$82.30
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.89
|
| Rate for Payer: Blue Distinction Transplant |
$1.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2.01
|
| Rate for Payer: Blue Shield of California EPN |
$1.56
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: Cigna of CA HMO |
$2.05
|
| Rate for Payer: Cigna of CA PPO |
$2.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.72
|
| Rate for Payer: Dignity Health Media |
$2.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
| Rate for Payer: Riverside University Health System MISP |
$1.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.72
|
| Rate for Payer: Vantage Medical Group Senior |
$2.72
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.64
|
| Rate for Payer: Multiplan Commercial |
$2.40
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 INTRAAORTIC 7FR 30CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 INTRAAORTIC 7FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 INTRAAORTIC 8FR 50CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
OP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,014.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,824.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,606.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,959.96
|
| Rate for Payer: Blue Distinction Transplant |
$1,990.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,086.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,622.24
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: Cigna of CA HMO |
$2,123.17
|
| Rate for Payer: Cigna of CA PPO |
$2,454.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Dignity Health Media |
$2,819.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,819.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,488.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,161.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Multiplan Commercial |
$2,488.10
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,326.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.73
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,819.84
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
IP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,985.71 |
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Central Health Plan Commercial |
$2,653.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,985.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.49
|
| Rate for Payer: Multiplan Commercial |
$2,488.10
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
IP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
OP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.10
|
| Rate for Payer: Blue Distinction Transplant |
$11.27
|
| Rate for Payer: Blue Shield of California Commercial |
$11.81
|
| Rate for Payer: Blue Shield of California EPN |
$9.18
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: Cigna of CA HMO |
$12.02
|
| Rate for Payer: Cigna of CA PPO |
$13.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.96
|
| Rate for Payer: Dignity Health Media |
$15.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
| Rate for Payer: Riverside University Health System MISP |
$7.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.39
|
| Rate for Payer: United Healthcare All Other HMO |
$9.39
|
| Rate for Payer: United Healthcare HMO Rider |
$9.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.96
|
| Rate for Payer: Vantage Medical Group Senior |
$15.96
|
|
