|
HC CATH MAGIC 3 INTMT 12FR FEMALE
|
Facility
|
OP
|
$11.07
|
|
| Hospital Charge Code |
901698146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.54
|
| Rate for Payer: Blue Distinction Transplant |
$6.64
|
| Rate for Payer: Blue Shield of California Commercial |
$6.96
|
| Rate for Payer: Blue Shield of California EPN |
$5.41
|
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.86
|
| Rate for Payer: Cigna of CA HMO |
$7.08
|
| Rate for Payer: Cigna of CA PPO |
$8.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.41
|
| Rate for Payer: Dignity Health Media |
$9.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.43
|
| Rate for Payer: Galaxy Health WC |
$9.41
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.96
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Multiplan Commercial |
$8.30
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$9.41
|
| Rate for Payer: Riverside University Health System MISP |
$4.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.54
|
| Rate for Payer: United Healthcare All Other HMO |
$5.54
|
| Rate for Payer: United Healthcare HMO Rider |
$5.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.41
|
|
|
HC CATH MAGIC 3 INTMT 12FR FEMALE
|
Facility
|
IP
|
$11.07
|
|
| Hospital Charge Code |
901698146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Cash Price |
$4.98
|
| Rate for Payer: Central Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.43
|
| Rate for Payer: Galaxy Health WC |
$9.41
|
| Rate for Payer: Global Benefits Group Commercial |
$6.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Multiplan Commercial |
$8.30
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$9.41
|
|
|
HC CATH MAHURKAR 10FR 12MM DBL
|
Facility
|
OP
|
$461.22
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.24 |
| Max. Negotiated Rate |
$415.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$392.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$253.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$253.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.90
|
| Rate for Payer: Blue Distinction Transplant |
$276.73
|
| Rate for Payer: Blue Shield of California Commercial |
$345.92
|
| Rate for Payer: Blue Shield of California EPN |
$250.90
|
| Rate for Payer: Cash Price |
$207.55
|
| Rate for Payer: Central Health Plan Commercial |
$368.98
|
| Rate for Payer: Cigna of CA HMO |
$322.85
|
| Rate for Payer: Cigna of CA PPO |
$322.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$392.04
|
| Rate for Payer: Dignity Health Media |
$392.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$392.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$184.49
|
| Rate for Payer: Galaxy Health WC |
$392.04
|
| Rate for Payer: Global Benefits Group Commercial |
$276.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$415.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$345.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$161.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.24
|
| Rate for Payer: Multiplan Commercial |
$345.92
|
| Rate for Payer: Networks By Design Commercial |
$230.61
|
| Rate for Payer: Prime Health Services Commercial |
$392.04
|
| Rate for Payer: Riverside University Health System MISP |
$184.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.61
|
| Rate for Payer: United Healthcare All Other HMO |
$230.61
|
| Rate for Payer: United Healthcare HMO Rider |
$230.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$230.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$392.04
|
| Rate for Payer: Vantage Medical Group Senior |
$392.04
|
|
|
HC CATH MAHURKAR 10FR 12MM DBL
|
Facility
|
IP
|
$461.22
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.24 |
| Max. Negotiated Rate |
$415.10 |
| Rate for Payer: Blue Shield of California EPN |
$246.29
|
| Rate for Payer: Cash Price |
$207.55
|
| Rate for Payer: Central Health Plan Commercial |
$368.98
|
| Rate for Payer: Cigna of CA HMO |
$322.85
|
| Rate for Payer: Cigna of CA PPO |
$322.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$184.49
|
| Rate for Payer: Galaxy Health WC |
$392.04
|
| Rate for Payer: Global Benefits Group Commercial |
$276.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$415.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.24
|
| Rate for Payer: Multiplan Commercial |
$345.92
|
| Rate for Payer: Prime Health Services Commercial |
$392.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$174.16
|
| Rate for Payer: United Healthcare All Other HMO |
$170.10
|
| Rate for Payer: United Healthcare HMO Rider |
$166.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$152.20
|
|
|
HC CATH MAHURKAR 11.5FR 13.5 CM
|
Facility
|
OP
|
$447.76
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.55 |
| Max. Negotiated Rate |
$402.98 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$380.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$246.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$246.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$204.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$249.40
|
| Rate for Payer: Blue Distinction Transplant |
$268.66
|
| Rate for Payer: Blue Shield of California Commercial |
$335.82
|
| Rate for Payer: Blue Shield of California EPN |
$243.58
|
| Rate for Payer: Cash Price |
$201.49
|
| Rate for Payer: Central Health Plan Commercial |
$358.21
|
| Rate for Payer: Cigna of CA HMO |
$313.43
|
| Rate for Payer: Cigna of CA PPO |
$313.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$380.60
|
| Rate for Payer: Dignity Health Media |
$380.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$380.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$179.10
|
| Rate for Payer: Galaxy Health WC |
$380.60
|
| Rate for Payer: Global Benefits Group Commercial |
$268.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.98
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$335.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$298.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.55
|
| Rate for Payer: Multiplan Commercial |
$335.82
|
| Rate for Payer: Networks By Design Commercial |
$223.88
|
| Rate for Payer: Prime Health Services Commercial |
$380.60
|
| Rate for Payer: Riverside University Health System MISP |
$179.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$268.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$268.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$223.88
|
| Rate for Payer: United Healthcare All Other HMO |
$223.88
|
| Rate for Payer: United Healthcare HMO Rider |
$223.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$380.60
|
| Rate for Payer: Vantage Medical Group Senior |
$380.60
|
|
|
HC CATH MAHURKAR 11.5FR 13.5 CM
|
Facility
|
IP
|
$447.76
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.55 |
| Max. Negotiated Rate |
$402.98 |
| Rate for Payer: Blue Shield of California EPN |
$239.10
|
| Rate for Payer: Cash Price |
$201.49
|
| Rate for Payer: Central Health Plan Commercial |
$358.21
|
| Rate for Payer: Cigna of CA HMO |
$313.43
|
| Rate for Payer: Cigna of CA PPO |
$313.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$179.10
|
| Rate for Payer: Galaxy Health WC |
$380.60
|
| Rate for Payer: Global Benefits Group Commercial |
$268.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$298.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.55
|
| Rate for Payer: Multiplan Commercial |
$335.82
|
| Rate for Payer: Prime Health Services Commercial |
$380.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$169.07
|
| Rate for Payer: United Healthcare All Other HMO |
$165.13
|
| Rate for Payer: United Healthcare HMO Rider |
$161.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$147.76
|
|
|
HC CATH MAHURKAR 11.5FR 19.5 CM
|
Facility
|
IP
|
$479.14
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.83 |
| Max. Negotiated Rate |
$431.23 |
| Rate for Payer: Blue Shield of California EPN |
$255.86
|
| Rate for Payer: Cash Price |
$215.61
|
| Rate for Payer: Central Health Plan Commercial |
$383.31
|
| Rate for Payer: Cigna of CA HMO |
$335.40
|
| Rate for Payer: Cigna of CA PPO |
$335.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$191.66
|
| Rate for Payer: Galaxy Health WC |
$407.27
|
| Rate for Payer: Global Benefits Group Commercial |
$287.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$319.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.83
|
| Rate for Payer: Multiplan Commercial |
$359.36
|
| Rate for Payer: Prime Health Services Commercial |
$407.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$180.92
|
| Rate for Payer: United Healthcare All Other HMO |
$176.71
|
| Rate for Payer: United Healthcare HMO Rider |
$172.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.12
|
|
|
HC CATH MAHURKAR 11.5FR 19.5 CM
|
Facility
|
OP
|
$479.14
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.83 |
| Max. Negotiated Rate |
$431.23 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$407.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$263.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$263.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$218.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.88
|
| Rate for Payer: Blue Distinction Transplant |
$287.48
|
| Rate for Payer: Blue Shield of California Commercial |
$359.36
|
| Rate for Payer: Blue Shield of California EPN |
$260.65
|
| Rate for Payer: Cash Price |
$215.61
|
| Rate for Payer: Central Health Plan Commercial |
$383.31
|
| Rate for Payer: Cigna of CA HMO |
$335.40
|
| Rate for Payer: Cigna of CA PPO |
$335.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$407.27
|
| Rate for Payer: Dignity Health Media |
$407.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$191.66
|
| Rate for Payer: Galaxy Health WC |
$407.27
|
| Rate for Payer: Global Benefits Group Commercial |
$287.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.23
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$167.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$319.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.83
|
| Rate for Payer: Multiplan Commercial |
$359.36
|
| Rate for Payer: Networks By Design Commercial |
$239.57
|
| Rate for Payer: Prime Health Services Commercial |
$407.27
|
| Rate for Payer: Riverside University Health System MISP |
$191.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$287.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$287.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$239.57
|
| Rate for Payer: United Healthcare All Other HMO |
$239.57
|
| Rate for Payer: United Healthcare HMO Rider |
$239.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$239.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.27
|
| Rate for Payer: Vantage Medical Group Senior |
$407.27
|
|
|
HC CATH MAHURKAR 12FR X 13CM
|
Facility
|
OP
|
$578.43
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.69 |
| Max. Negotiated Rate |
$520.59 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$491.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$318.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$318.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$322.19
|
| Rate for Payer: Blue Distinction Transplant |
$347.06
|
| Rate for Payer: Blue Shield of California Commercial |
$433.82
|
| Rate for Payer: Blue Shield of California EPN |
$314.67
|
| Rate for Payer: Cash Price |
$260.29
|
| Rate for Payer: Central Health Plan Commercial |
$462.74
|
| Rate for Payer: Cigna of CA HMO |
$404.90
|
| Rate for Payer: Cigna of CA PPO |
$404.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$491.67
|
| Rate for Payer: Dignity Health Media |
$491.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$491.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$231.37
|
| Rate for Payer: Galaxy Health WC |
$491.67
|
| Rate for Payer: Global Benefits Group Commercial |
$347.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$520.59
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$433.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$202.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$385.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.69
|
| Rate for Payer: Multiplan Commercial |
$433.82
|
| Rate for Payer: Networks By Design Commercial |
$289.22
|
| Rate for Payer: Prime Health Services Commercial |
$491.67
|
| Rate for Payer: Riverside University Health System MISP |
$231.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$347.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$347.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.22
|
| Rate for Payer: United Healthcare All Other HMO |
$289.22
|
| Rate for Payer: United Healthcare HMO Rider |
$289.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$289.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$491.67
|
| Rate for Payer: Vantage Medical Group Senior |
$491.67
|
|
|
HC CATH MAHURKAR 12FR X 13CM
|
Facility
|
IP
|
$578.43
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.69 |
| Max. Negotiated Rate |
$520.59 |
| Rate for Payer: Blue Shield of California EPN |
$308.88
|
| Rate for Payer: Cash Price |
$260.29
|
| Rate for Payer: Central Health Plan Commercial |
$462.74
|
| Rate for Payer: Cigna of CA HMO |
$404.90
|
| Rate for Payer: Cigna of CA PPO |
$404.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$231.37
|
| Rate for Payer: Galaxy Health WC |
$491.67
|
| Rate for Payer: Global Benefits Group Commercial |
$347.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$520.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$385.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.69
|
| Rate for Payer: Multiplan Commercial |
$433.82
|
| Rate for Payer: Prime Health Services Commercial |
$491.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$218.42
|
| Rate for Payer: United Healthcare All Other HMO |
$213.32
|
| Rate for Payer: United Healthcare HMO Rider |
$208.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.88
|
|
|
HC CATH MAHURKAR TL ST 12FR 16CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH MAHURKAR TL ST 12FR 16CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH MAHURKAR TL ST 12FR 20CM
|
Facility
|
IP
|
$584.57
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.91 |
| Max. Negotiated Rate |
$526.11 |
| Rate for Payer: Blue Shield of California EPN |
$312.16
|
| Rate for Payer: Cash Price |
$263.06
|
| Rate for Payer: Central Health Plan Commercial |
$467.66
|
| Rate for Payer: Cigna of CA HMO |
$409.20
|
| Rate for Payer: Cigna of CA PPO |
$409.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.83
|
| Rate for Payer: Galaxy Health WC |
$496.88
|
| Rate for Payer: Global Benefits Group Commercial |
$350.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$526.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.91
|
| Rate for Payer: Multiplan Commercial |
$438.43
|
| Rate for Payer: Prime Health Services Commercial |
$496.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$220.73
|
| Rate for Payer: United Healthcare All Other HMO |
$215.59
|
| Rate for Payer: United Healthcare HMO Rider |
$210.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$192.91
|
|
|
HC CATH MAHURKAR TL ST 12FR 20CM
|
Facility
|
OP
|
$584.57
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.91 |
| Max. Negotiated Rate |
$526.11 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$496.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$321.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$266.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$325.61
|
| Rate for Payer: Blue Distinction Transplant |
$350.74
|
| Rate for Payer: Blue Shield of California Commercial |
$438.43
|
| Rate for Payer: Blue Shield of California EPN |
$318.01
|
| Rate for Payer: Cash Price |
$263.06
|
| Rate for Payer: Central Health Plan Commercial |
$467.66
|
| Rate for Payer: Cigna of CA HMO |
$409.20
|
| Rate for Payer: Cigna of CA PPO |
$409.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$496.88
|
| Rate for Payer: Dignity Health Media |
$496.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$496.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.83
|
| Rate for Payer: Galaxy Health WC |
$496.88
|
| Rate for Payer: Global Benefits Group Commercial |
$350.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$526.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$438.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$204.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.91
|
| Rate for Payer: Multiplan Commercial |
$438.43
|
| Rate for Payer: Networks By Design Commercial |
$292.28
|
| Rate for Payer: Prime Health Services Commercial |
$496.88
|
| Rate for Payer: Riverside University Health System MISP |
$233.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$350.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$350.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$292.28
|
| Rate for Payer: United Healthcare All Other HMO |
$292.28
|
| Rate for Payer: United Healthcare HMO Rider |
$292.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$292.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$496.88
|
| Rate for Payer: Vantage Medical Group Senior |
$496.88
|
|
|
HC CATH MALE EXT .21MM SPORT
|
Facility
|
IP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
|
|
HC CATH MALE EXT .21MM SPORT
|
Facility
|
OP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.73
|
| Rate for Payer: Blue Distinction Transplant |
$115.50
|
| Rate for Payer: Blue Shield of California Commercial |
$121.08
|
| Rate for Payer: Blue Shield of California EPN |
$94.13
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: Cigna of CA HMO |
$123.20
|
| Rate for Payer: Cigna of CA PPO |
$142.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.62
|
| Rate for Payer: Dignity Health Media |
$163.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$144.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
| Rate for Payer: Riverside University Health System MISP |
$77.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.25
|
| Rate for Payer: United Healthcare All Other HMO |
$96.25
|
| Rate for Payer: United Healthcare HMO Rider |
$96.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.62
|
| Rate for Payer: Vantage Medical Group Senior |
$163.62
|
|
|
HC CATH MALE EXT .25MM SPORT
|
Facility
|
OP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.73
|
| Rate for Payer: Blue Distinction Transplant |
$115.50
|
| Rate for Payer: Blue Shield of California Commercial |
$121.08
|
| Rate for Payer: Blue Shield of California EPN |
$94.13
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: Cigna of CA HMO |
$123.20
|
| Rate for Payer: Cigna of CA PPO |
$142.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.62
|
| Rate for Payer: Dignity Health Media |
$163.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$144.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
| Rate for Payer: Riverside University Health System MISP |
$77.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.25
|
| Rate for Payer: United Healthcare All Other HMO |
$96.25
|
| Rate for Payer: United Healthcare HMO Rider |
$96.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.62
|
| Rate for Payer: Vantage Medical Group Senior |
$163.62
|
|
|
HC CATH MALE EXT .25MM SPORT
|
Facility
|
IP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
|
|
HC CATH MALE EXT .25MM STANDARD
|
Facility
|
IP
|
$9.68
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Central Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.87
|
| Rate for Payer: Galaxy Health WC |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$5.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: Multiplan Commercial |
$7.26
|
| Rate for Payer: Networks By Design Commercial |
$6.29
|
| Rate for Payer: Prime Health Services Commercial |
$8.23
|
|
|
HC CATH MALE EXT .25MM STANDARD
|
Facility
|
OP
|
$9.68
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607605
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.72
|
| Rate for Payer: Blue Distinction Transplant |
$5.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6.09
|
| Rate for Payer: Blue Shield of California EPN |
$4.73
|
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Central Health Plan Commercial |
$7.74
|
| Rate for Payer: Cigna of CA HMO |
$6.20
|
| Rate for Payer: Cigna of CA PPO |
$7.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.23
|
| Rate for Payer: Dignity Health Media |
$8.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.87
|
| Rate for Payer: Galaxy Health WC |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$5.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: Multiplan Commercial |
$7.26
|
| Rate for Payer: Networks By Design Commercial |
$6.29
|
| Rate for Payer: Prime Health Services Commercial |
$8.23
|
| Rate for Payer: Riverside University Health System MISP |
$3.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.84
|
| Rate for Payer: United Healthcare All Other HMO |
$4.84
|
| Rate for Payer: United Healthcare HMO Rider |
$4.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$8.23
|
|
|
HC CATH MALE EXT .28MM STANDARD
|
Facility
|
OP
|
$9.76
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$8.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.77
|
| Rate for Payer: Blue Distinction Transplant |
$5.86
|
| Rate for Payer: Blue Shield of California Commercial |
$6.14
|
| Rate for Payer: Blue Shield of California EPN |
$4.77
|
| Rate for Payer: Cash Price |
$4.39
|
| Rate for Payer: Cash Price |
$4.39
|
| Rate for Payer: Central Health Plan Commercial |
$7.81
|
| Rate for Payer: Cigna of CA HMO |
$6.25
|
| Rate for Payer: Cigna of CA PPO |
$7.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.30
|
| Rate for Payer: Dignity Health Media |
$8.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.90
|
| Rate for Payer: Galaxy Health WC |
$8.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.78
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.95
|
| Rate for Payer: Multiplan Commercial |
$7.32
|
| Rate for Payer: Networks By Design Commercial |
$6.34
|
| Rate for Payer: Prime Health Services Commercial |
$8.30
|
| Rate for Payer: Riverside University Health System MISP |
$3.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.88
|
| Rate for Payer: United Healthcare All Other HMO |
$4.88
|
| Rate for Payer: United Healthcare HMO Rider |
$4.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.30
|
| Rate for Payer: Vantage Medical Group Senior |
$8.30
|
|
|
HC CATH MALE EXT .28MM STANDARD
|
Facility
|
IP
|
$9.76
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607607
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$8.78 |
| Rate for Payer: Cash Price |
$4.39
|
| Rate for Payer: Central Health Plan Commercial |
$7.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.90
|
| Rate for Payer: Galaxy Health WC |
$8.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.95
|
| Rate for Payer: Multiplan Commercial |
$7.32
|
| Rate for Payer: Networks By Design Commercial |
$6.34
|
| Rate for Payer: Prime Health Services Commercial |
$8.30
|
|
|
HC CATH MALE EXT .30MM SPORT
|
Facility
|
IP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
|
|
HC CATH MALE EXT .30MM SPORT
|
Facility
|
OP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.73
|
| Rate for Payer: Blue Distinction Transplant |
$115.50
|
| Rate for Payer: Blue Shield of California Commercial |
$121.08
|
| Rate for Payer: Blue Shield of California EPN |
$94.13
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: Cigna of CA HMO |
$123.20
|
| Rate for Payer: Cigna of CA PPO |
$142.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.62
|
| Rate for Payer: Dignity Health Media |
$163.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$144.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
| Rate for Payer: Riverside University Health System MISP |
$77.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.25
|
| Rate for Payer: United Healthcare All Other HMO |
$96.25
|
| Rate for Payer: United Healthcare HMO Rider |
$96.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.62
|
| Rate for Payer: Vantage Medical Group Senior |
$163.62
|
|
|
HC CATH MALE EXT .30MM STANDARD
|
Facility
|
IP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
|
