|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
IP
|
$74.54
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$67.09 |
| Rate for Payer: Cash Price |
$33.54
|
| Rate for Payer: Central Health Plan Commercial |
$59.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.82
|
| Rate for Payer: Galaxy Health WC |
$63.36
|
| Rate for Payer: Global Benefits Group Commercial |
$44.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.91
|
| Rate for Payer: Multiplan Commercial |
$55.90
|
| Rate for Payer: Networks By Design Commercial |
$48.45
|
| Rate for Payer: Prime Health Services Commercial |
$63.36
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
OP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.42
|
| Rate for Payer: Blue Distinction Transplant |
$39.02
|
| Rate for Payer: Blue Shield of California Commercial |
$40.90
|
| Rate for Payer: Blue Shield of California EPN |
$31.80
|
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: Cigna of CA HMO |
$41.62
|
| Rate for Payer: Cigna of CA PPO |
$48.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.28
|
| Rate for Payer: Dignity Health Media |
$55.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$48.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Riverside University Health System MISP |
$26.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.52
|
| Rate for Payer: United Healthcare All Other HMO |
$32.52
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.28
|
| Rate for Payer: Vantage Medical Group Senior |
$55.28
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
IP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
IP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Blue Shield of California EPN |
$703.96
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$497.78
|
| Rate for Payer: United Healthcare All Other HMO |
$486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$475.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$435.03
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
OP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$725.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$725.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$601.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$734.28
|
| Rate for Payer: Blue Distinction Transplant |
$790.96
|
| Rate for Payer: Blue Shield of California Commercial |
$988.70
|
| Rate for Payer: Blue Shield of California EPN |
$717.14
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Dignity Health Media |
$1,120.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,120.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$988.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$461.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Networks By Design Commercial |
$659.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: Riverside University Health System MISP |
$527.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$790.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$790.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$659.14
|
| Rate for Payer: United Healthcare All Other HMO |
$659.14
|
| Rate for Payer: United Healthcare HMO Rider |
$659.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$659.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,120.53
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
IP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Blue Shield of California EPN |
$257.60
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.15
|
| Rate for Payer: United Healthcare All Other HMO |
$177.91
|
| Rate for Payer: United Healthcare HMO Rider |
$174.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.19
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
OP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$265.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$220.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$268.69
|
| Rate for Payer: Blue Distinction Transplant |
$289.43
|
| Rate for Payer: Blue Shield of California Commercial |
$361.79
|
| Rate for Payer: Blue Shield of California EPN |
$262.42
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.03
|
| Rate for Payer: Dignity Health Media |
$410.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$361.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$168.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Networks By Design Commercial |
$241.20
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: Riverside University Health System MISP |
$192.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$241.20
|
| Rate for Payer: United Healthcare All Other HMO |
$241.20
|
| Rate for Payer: United Healthcare HMO Rider |
$241.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$241.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.03
|
| Rate for Payer: Vantage Medical Group Senior |
$410.03
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$132.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$119.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.49
|
| Rate for Payer: Blue Distinction Transplant |
$130.49
|
| Rate for Payer: Blue Shield of California Commercial |
$136.80
|
| Rate for Payer: Blue Shield of California EPN |
$106.35
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: Cigna of CA HMO |
$139.19
|
| Rate for Payer: Cigna of CA PPO |
$160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.87
|
| Rate for Payer: Dignity Health Media |
$184.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$163.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$76.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
| Rate for Payer: Riverside University Health System MISP |
$87.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.74
|
| Rate for Payer: United Healthcare All Other HMO |
$108.74
|
| Rate for Payer: United Healthcare HMO Rider |
$108.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.87
|
| Rate for Payer: Vantage Medical Group Senior |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$72.49
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.50 |
| Max. Negotiated Rate |
$65.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.83
|
| Rate for Payer: Blue Distinction Transplant |
$43.49
|
| Rate for Payer: Blue Shield of California Commercial |
$45.60
|
| Rate for Payer: Blue Shield of California EPN |
$35.45
|
| Rate for Payer: Cash Price |
$32.62
|
| Rate for Payer: Central Health Plan Commercial |
$57.99
|
| Rate for Payer: Cigna of CA HMO |
$46.39
|
| Rate for Payer: Cigna of CA PPO |
$53.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.62
|
| Rate for Payer: Dignity Health Media |
$61.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$61.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.00
|
| Rate for Payer: Galaxy Health WC |
$61.62
|
| Rate for Payer: Global Benefits Group Commercial |
$43.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.24
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$54.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.50
|
| Rate for Payer: Multiplan Commercial |
$54.37
|
| Rate for Payer: Networks By Design Commercial |
$47.12
|
| Rate for Payer: Prime Health Services Commercial |
$61.62
|
| Rate for Payer: Riverside University Health System MISP |
$29.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$36.24
|
| Rate for Payer: United Healthcare All Other HMO |
$36.24
|
| Rate for Payer: United Healthcare HMO Rider |
$36.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$61.62
|
| Rate for Payer: Vantage Medical Group Senior |
$61.62
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$72.49
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.50 |
| Max. Negotiated Rate |
$65.24 |
| Rate for Payer: Cash Price |
$32.62
|
| Rate for Payer: Central Health Plan Commercial |
$57.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.00
|
| Rate for Payer: Galaxy Health WC |
$61.62
|
| Rate for Payer: Global Benefits Group Commercial |
$43.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.50
|
| Rate for Payer: Multiplan Commercial |
$54.37
|
| Rate for Payer: Networks By Design Commercial |
$47.12
|
| Rate for Payer: Prime Health Services Commercial |
$61.62
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
OP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$204.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$180.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.72
|
| Rate for Payer: Blue Distinction Transplant |
$223.14
|
| Rate for Payer: Blue Shield of California Commercial |
$233.93
|
| Rate for Payer: Blue Shield of California EPN |
$181.86
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: Cigna of CA HMO |
$238.02
|
| Rate for Payer: Cigna of CA PPO |
$275.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$316.12
|
| Rate for Payer: Dignity Health Media |
$316.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$316.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$278.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Multiplan Commercial |
$278.92
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
| Rate for Payer: Riverside University Health System MISP |
$148.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$185.95
|
| Rate for Payer: United Healthcare All Other HMO |
$185.95
|
| Rate for Payer: United Healthcare HMO Rider |
$185.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$316.12
|
| Rate for Payer: Vantage Medical Group Senior |
$316.12
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
IP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$334.71 |
| Rate for Payer: Cash Price |
$167.36
|
| Rate for Payer: Central Health Plan Commercial |
$297.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$334.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.38
|
| Rate for Payer: Multiplan Commercial |
$278.92
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
OP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$404.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$366.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$366.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$322.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$393.74
|
| Rate for Payer: Blue Distinction Transplant |
$399.87
|
| Rate for Payer: Blue Shield of California Commercial |
$419.20
|
| Rate for Payer: Blue Shield of California EPN |
$325.89
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: Cigna of CA HMO |
$426.53
|
| Rate for Payer: Cigna of CA PPO |
$493.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$566.48
|
| Rate for Payer: Dignity Health Media |
$566.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$499.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
| Rate for Payer: Riverside University Health System MISP |
$266.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.22
|
| Rate for Payer: United Healthcare All Other HMO |
$333.22
|
| Rate for Payer: United Healthcare HMO Rider |
$333.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$333.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.48
|
| Rate for Payer: Vantage Medical Group Senior |
$566.48
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
IP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$599.80 |
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Central Health Plan Commercial |
$533.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$599.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.29
|
| Rate for Payer: Multiplan Commercial |
$499.84
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
|
|
HC CATH RESCUE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH RESCUE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| 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 |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 RESCUE SUCTION OMNEOTECH
|
Facility
|
OP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$227.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$205.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$221.02
|
| Rate for Payer: Blue Distinction Transplant |
$224.46
|
| Rate for Payer: Blue Shield of California Commercial |
$235.31
|
| Rate for Payer: Blue Shield of California EPN |
$182.93
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: Cigna of CA HMO |
$239.42
|
| Rate for Payer: Cigna of CA PPO |
$276.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.98
|
| Rate for Payer: Dignity Health Media |
$317.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.98
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$280.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Multiplan Commercial |
$280.58
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.98
|
| Rate for Payer: Riverside University Health System MISP |
$149.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$187.05
|
| Rate for Payer: United Healthcare All Other HMO |
$187.05
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$187.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.98
|
| Rate for Payer: Vantage Medical Group Senior |
$317.98
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
IP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$336.69 |
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Central Health Plan Commercial |
$299.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.98
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.82
|
| Rate for Payer: Multiplan Commercial |
$280.58
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.98
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
IP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Central Health Plan Commercial |
$39.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.79
|
| Rate for Payer: Multiplan Commercial |
$36.71
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
OP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.92
|
| Rate for Payer: Blue Distinction Transplant |
$29.37
|
| Rate for Payer: Blue Shield of California Commercial |
$30.79
|
| Rate for Payer: Blue Shield of California EPN |
$23.94
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Central Health Plan Commercial |
$39.16
|
| Rate for Payer: Cigna of CA HMO |
$31.33
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.61
|
| Rate for Payer: Dignity Health Media |
$41.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$36.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.79
|
| Rate for Payer: Multiplan Commercial |
$36.71
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
| Rate for Payer: Riverside University Health System MISP |
$19.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.48
|
| Rate for Payer: United Healthcare All Other HMO |
$24.48
|
| Rate for Payer: United Healthcare HMO Rider |
$24.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.61
|
| Rate for Payer: Vantage Medical Group Senior |
$41.61
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
OP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.76
|
| Rate for Payer: Blue Distinction Transplant |
$2.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.94
|
| Rate for Payer: Blue Shield of California EPN |
$2.28
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Central Health Plan Commercial |
$3.74
|
| Rate for Payer: Cigna of CA HMO |
$2.99
|
| Rate for Payer: Cigna of CA PPO |
$3.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.97
|
| Rate for Payer: Dignity Health Media |
$3.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.93
|
| Rate for Payer: Multiplan Commercial |
$3.50
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
| Rate for Payer: Riverside University Health System MISP |
$1.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.34
|
| Rate for Payer: United Healthcare All Other HMO |
$2.34
|
| Rate for Payer: United Healthcare HMO Rider |
$2.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.97
|
| Rate for Payer: Vantage Medical Group Senior |
$3.97
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
IP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Central Health Plan Commercial |
$3.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.93
|
| Rate for Payer: Multiplan Commercial |
$3.50
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
OP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$527.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$420.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.64
|
| Rate for Payer: Blue Distinction Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$546.85
|
| Rate for Payer: Blue Shield of California EPN |
$425.14
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$556.42
|
| Rate for Payer: Cigna of CA PPO |
$643.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Media |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$652.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Riverside University Health System MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
IP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
