|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
IP
|
$1,399.04
|
|
| Hospital Charge Code |
901698451
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$279.81 |
| Max. Negotiated Rate |
$1,259.14 |
| Rate for Payer: Cash Price |
$629.57
|
| Rate for Payer: Central Health Plan Commercial |
$1,119.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$559.62
|
| Rate for Payer: Galaxy Health WC |
$1,189.18
|
| Rate for Payer: Global Benefits Group Commercial |
$839.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,259.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.81
|
| Rate for Payer: Multiplan Commercial |
$1,049.28
|
| Rate for Payer: Networks By Design Commercial |
$909.38
|
| Rate for Payer: Prime Health Services Commercial |
$1,189.18
|
|
|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
OP
|
$1,399.04
|
|
| Hospital Charge Code |
901698451
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$279.81 |
| Max. Negotiated Rate |
$1,259.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$849.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,189.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$769.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$769.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$677.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$826.55
|
| Rate for Payer: BCBS Transplant Transplant |
$839.42
|
| Rate for Payer: Blue Shield of California Commercial |
$880.00
|
| Rate for Payer: Blue Shield of California EPN |
$684.13
|
| Rate for Payer: Cash Price |
$629.57
|
| Rate for Payer: Central Health Plan Commercial |
$1,119.23
|
| Rate for Payer: Cigna of CA HMO |
$895.39
|
| Rate for Payer: Cigna of CA PPO |
$1,035.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,189.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$559.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$559.62
|
| Rate for Payer: Galaxy Health WC |
$1,189.18
|
| Rate for Payer: Global Benefits Group Commercial |
$839.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,259.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,049.28
|
| Rate for Payer: IEHP medi-cal |
$489.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.81
|
| Rate for Payer: Multiplan Commercial |
$1,049.28
|
| Rate for Payer: Networks By Design Commercial |
$909.38
|
| Rate for Payer: Prime Health Services Commercial |
$1,189.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$839.42
|
| Rate for Payer: Riverside University Health MISP |
$559.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$839.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$839.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.52
|
| Rate for Payer: United Healthcare All Other HMO |
$699.52
|
| Rate for Payer: United Healthcare HMO Rider |
$699.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,189.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,189.18
|
|
|
HC CATH SWANZ GANZ TL
|
Facility
OP
|
$580.00
|
|
| Hospital Charge Code |
901607753
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: Riverside University Health 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 SWANZ GANZ TL
|
Facility
IP
|
$580.00
|
|
| Hospital Charge Code |
901607753
|
|
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: 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 TERUMO OPTITORQUE
|
Facility
OP
|
$273.00
|
|
| Hospital Charge Code |
906812393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$165.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$150.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$150.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$132.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.29
|
| Rate for Payer: BCBS Transplant Transplant |
$163.80
|
| Rate for Payer: Blue Shield of California Commercial |
$171.72
|
| Rate for Payer: Blue Shield of California EPN |
$133.50
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Central Health Plan Commercial |
$218.40
|
| Rate for Payer: Cigna of CA HMO |
$174.72
|
| Rate for Payer: Cigna of CA PPO |
$202.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.20
|
| Rate for Payer: Galaxy Health WC |
$232.05
|
| Rate for Payer: Global Benefits Group Commercial |
$163.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$245.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$204.75
|
| Rate for Payer: IEHP medi-cal |
$95.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$204.75
|
| Rate for Payer: Networks By Design Commercial |
$177.45
|
| Rate for Payer: Prime Health Services Commercial |
$232.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$163.80
|
| Rate for Payer: Riverside University Health MISP |
$109.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$163.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$163.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.50
|
| Rate for Payer: United Healthcare All Other HMO |
$136.50
|
| Rate for Payer: United Healthcare HMO Rider |
$136.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.05
|
| Rate for Payer: Vantage Medical Group Senior |
$232.05
|
|
|
HC CATH TERUMO OPTITORQUE
|
Facility
IP
|
$273.00
|
|
| Hospital Charge Code |
906812393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Central Health Plan Commercial |
$218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.20
|
| Rate for Payer: Galaxy Health WC |
$232.05
|
| Rate for Payer: Global Benefits Group Commercial |
$163.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$245.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$204.75
|
| Rate for Payer: Networks By Design Commercial |
$177.45
|
| Rate for Payer: Prime Health Services Commercial |
$232.05
|
|
|
HC CATH THAL-QUICK 12FR CHEST
|
Facility
IP
|
$643.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.64 |
| Max. Negotiated Rate |
$578.90 |
| Rate for Payer: Blue Shield of California EPN |
$343.48
|
| Rate for Payer: Cash Price |
$289.45
|
| Rate for Payer: Central Health Plan Commercial |
$514.58
|
| Rate for Payer: Cigna of CA HMO |
$450.25
|
| Rate for Payer: Cigna of CA PPO |
$450.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$257.29
|
| Rate for Payer: Galaxy Health WC |
$546.74
|
| Rate for Payer: Global Benefits Group Commercial |
$385.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$578.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$429.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.64
|
| Rate for Payer: Multiplan Commercial |
$482.42
|
| Rate for Payer: Prime Health Services Commercial |
$546.74
|
|
|
HC CATH THAL-QUICK 12FR CHEST
|
Facility
OP
|
$643.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.64 |
| Max. Negotiated Rate |
$578.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$546.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$353.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$353.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$293.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.27
|
| Rate for Payer: BCBS Transplant Transplant |
$385.93
|
| Rate for Payer: Blue Shield of California Commercial |
$482.42
|
| Rate for Payer: Blue Shield of California EPN |
$349.91
|
| Rate for Payer: Cash Price |
$289.45
|
| Rate for Payer: Cash Price |
$289.45
|
| Rate for Payer: Central Health Plan Commercial |
$514.58
|
| Rate for Payer: Cigna of CA HMO |
$450.25
|
| Rate for Payer: Cigna of CA PPO |
$450.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$546.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$257.29
|
| Rate for Payer: Galaxy Health WC |
$546.74
|
| Rate for Payer: Global Benefits Group Commercial |
$385.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$578.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$482.42
|
| Rate for Payer: IEHP medi-cal |
$225.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$429.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.64
|
| Rate for Payer: Multiplan Commercial |
$482.42
|
| Rate for Payer: Networks By Design Commercial |
$321.61
|
| Rate for Payer: Prime Health Services Commercial |
$546.74
|
| Rate for Payer: Riverside University Health MISP |
$257.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$385.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$321.61
|
| Rate for Payer: United Healthcare All Other HMO |
$321.61
|
| Rate for Payer: United Healthcare HMO Rider |
$321.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$321.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$546.74
|
| Rate for Payer: Vantage Medical Group Senior |
$546.74
|
|
|
HC CATH THAL-QUICK 16FR CHEST
|
Facility
OP
|
$656.47
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.29 |
| Max. Negotiated Rate |
$590.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$558.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$361.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$361.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$299.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$365.65
|
| Rate for Payer: BCBS Transplant Transplant |
$393.88
|
| Rate for Payer: Blue Shield of California Commercial |
$492.35
|
| Rate for Payer: Blue Shield of California EPN |
$357.12
|
| Rate for Payer: Cash Price |
$295.41
|
| Rate for Payer: Cash Price |
$295.41
|
| Rate for Payer: Central Health Plan Commercial |
$525.18
|
| Rate for Payer: Cigna of CA HMO |
$459.53
|
| Rate for Payer: Cigna of CA PPO |
$459.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$558.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$262.59
|
| Rate for Payer: Galaxy Health WC |
$558.00
|
| Rate for Payer: Global Benefits Group Commercial |
$393.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$590.82
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$492.35
|
| Rate for Payer: IEHP medi-cal |
$229.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$437.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.29
|
| Rate for Payer: Multiplan Commercial |
$492.35
|
| Rate for Payer: Networks By Design Commercial |
$328.24
|
| Rate for Payer: Prime Health Services Commercial |
$558.00
|
| Rate for Payer: Riverside University Health MISP |
$262.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$393.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$393.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.24
|
| Rate for Payer: United Healthcare All Other HMO |
$328.24
|
| Rate for Payer: United Healthcare HMO Rider |
$328.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.00
|
| Rate for Payer: Vantage Medical Group Senior |
$558.00
|
|
|
HC CATH THAL-QUICK 16FR CHEST
|
Facility
IP
|
$656.47
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.29 |
| Max. Negotiated Rate |
$590.82 |
| Rate for Payer: Blue Shield of California EPN |
$350.55
|
| Rate for Payer: Cash Price |
$295.41
|
| Rate for Payer: Central Health Plan Commercial |
$525.18
|
| Rate for Payer: Cigna of CA HMO |
$459.53
|
| Rate for Payer: Cigna of CA PPO |
$459.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$262.59
|
| Rate for Payer: Galaxy Health WC |
$558.00
|
| Rate for Payer: Global Benefits Group Commercial |
$393.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$590.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$437.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.29
|
| Rate for Payer: Multiplan Commercial |
$492.35
|
| Rate for Payer: Prime Health Services Commercial |
$558.00
|
|
|
HC CATH THAL-QUICK 18FR CHEST
|
Facility
OP
|
$680.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.04 |
| Max. Negotiated Rate |
$612.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$578.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$374.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$374.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$310.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$378.87
|
| Rate for Payer: BCBS Transplant Transplant |
$408.12
|
| Rate for Payer: Blue Shield of California Commercial |
$510.15
|
| Rate for Payer: Blue Shield of California EPN |
$370.03
|
| Rate for Payer: Cash Price |
$306.09
|
| Rate for Payer: Cash Price |
$306.09
|
| Rate for Payer: Central Health Plan Commercial |
$544.16
|
| Rate for Payer: Cigna of CA HMO |
$476.14
|
| Rate for Payer: Cigna of CA PPO |
$476.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$578.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$272.08
|
| Rate for Payer: Galaxy Health WC |
$578.17
|
| Rate for Payer: Global Benefits Group Commercial |
$408.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$612.18
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$510.15
|
| Rate for Payer: IEHP medi-cal |
$238.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$453.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.04
|
| Rate for Payer: Multiplan Commercial |
$510.15
|
| Rate for Payer: Networks By Design Commercial |
$340.10
|
| Rate for Payer: Prime Health Services Commercial |
$578.17
|
| Rate for Payer: Riverside University Health MISP |
$272.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$408.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$408.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.10
|
| Rate for Payer: United Healthcare All Other HMO |
$340.10
|
| Rate for Payer: United Healthcare HMO Rider |
$340.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$340.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$578.17
|
| Rate for Payer: Vantage Medical Group Senior |
$578.17
|
|
|
HC CATH THAL-QUICK 18FR CHEST
|
Facility
IP
|
$680.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.04 |
| Max. Negotiated Rate |
$612.18 |
| Rate for Payer: Blue Shield of California EPN |
$363.23
|
| Rate for Payer: Cash Price |
$306.09
|
| Rate for Payer: Central Health Plan Commercial |
$544.16
|
| Rate for Payer: Cigna of CA HMO |
$476.14
|
| Rate for Payer: Cigna of CA PPO |
$476.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$272.08
|
| Rate for Payer: Galaxy Health WC |
$578.17
|
| Rate for Payer: Global Benefits Group Commercial |
$408.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$612.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$453.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.04
|
| Rate for Payer: Multiplan Commercial |
$510.15
|
| Rate for Payer: Prime Health Services Commercial |
$578.17
|
|
|
HC CATH THERMODILUTN 7FR 4 LUMEN
|
Facility
IP
|
$355.77
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$320.19 |
| Rate for Payer: Cash Price |
$160.10
|
| Rate for Payer: Central Health Plan Commercial |
$284.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.31
|
| Rate for Payer: Galaxy Health WC |
$302.40
|
| Rate for Payer: Global Benefits Group Commercial |
$213.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$320.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$237.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.15
|
| Rate for Payer: Multiplan Commercial |
$266.83
|
| Rate for Payer: Networks By Design Commercial |
$231.25
|
| Rate for Payer: Prime Health Services Commercial |
$302.40
|
|
|
HC CATH THERMODILUTN 7FR 4 LUMEN
|
Facility
OP
|
$355.77
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$302.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$195.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$172.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$210.19
|
| Rate for Payer: BCBS Transplant Transplant |
$213.46
|
| Rate for Payer: Blue Shield of California Commercial |
$223.78
|
| Rate for Payer: Blue Shield of California EPN |
$173.97
|
| Rate for Payer: Cash Price |
$160.10
|
| Rate for Payer: Cash Price |
$160.10
|
| Rate for Payer: Central Health Plan Commercial |
$284.62
|
| Rate for Payer: Cigna of CA HMO |
$227.69
|
| Rate for Payer: Cigna of CA PPO |
$263.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$302.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$142.31
|
| Rate for Payer: Galaxy Health WC |
$302.40
|
| Rate for Payer: Global Benefits Group Commercial |
$213.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$320.19
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$266.83
|
| Rate for Payer: IEHP medi-cal |
$124.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$237.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.15
|
| Rate for Payer: Multiplan Commercial |
$266.83
|
| Rate for Payer: Networks By Design Commercial |
$231.25
|
| Rate for Payer: Prime Health Services Commercial |
$302.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$213.46
|
| Rate for Payer: Riverside University Health MISP |
$142.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$213.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$213.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$177.88
|
| Rate for Payer: United Healthcare All Other HMO |
$177.88
|
| Rate for Payer: United Healthcare HMO Rider |
$177.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$177.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$302.40
|
| Rate for Payer: Vantage Medical Group Senior |
$302.40
|
|
|
HC CATH THORACIC 12FR CHEST TUBE
|
Facility
IP
|
$33.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$29.82 |
| Rate for Payer: Blue Shield of California EPN |
$17.69
|
| Rate for Payer: Cash Price |
$14.91
|
| Rate for Payer: Central Health Plan Commercial |
$26.50
|
| Rate for Payer: Cigna of CA HMO |
$23.19
|
| Rate for Payer: Cigna of CA PPO |
$23.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$28.16
|
| Rate for Payer: Global Benefits Group Commercial |
$19.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$24.85
|
| Rate for Payer: Prime Health Services Commercial |
$28.16
|
|
|
HC CATH THORACIC 12FR CHEST TUBE
|
Facility
OP
|
$33.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.45
|
| Rate for Payer: BCBS Transplant Transplant |
$19.88
|
| Rate for Payer: Blue Shield of California Commercial |
$24.85
|
| Rate for Payer: Blue Shield of California EPN |
$18.02
|
| Rate for Payer: Cash Price |
$14.91
|
| Rate for Payer: Cash Price |
$14.91
|
| Rate for Payer: Central Health Plan Commercial |
$26.50
|
| Rate for Payer: Cigna of CA HMO |
$23.19
|
| Rate for Payer: Cigna of CA PPO |
$23.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$28.16
|
| Rate for Payer: Global Benefits Group Commercial |
$19.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.82
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.85
|
| Rate for Payer: IEHP medi-cal |
$11.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$24.85
|
| Rate for Payer: Networks By Design Commercial |
$16.56
|
| Rate for Payer: Prime Health Services Commercial |
$28.16
|
| Rate for Payer: Riverside University Health MISP |
$13.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.56
|
| Rate for Payer: United Healthcare All Other HMO |
$16.56
|
| Rate for Payer: United Healthcare HMO Rider |
$16.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.16
|
| Rate for Payer: Vantage Medical Group Senior |
$28.16
|
|
|
HC CATH THORACIC 16FR CHEST TUBE
|
Facility
OP
|
$44.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601397
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.66
|
| Rate for Payer: BCBS Transplant Transplant |
$26.57
|
| Rate for Payer: Blue Shield of California Commercial |
$33.21
|
| Rate for Payer: Blue Shield of California EPN |
$24.09
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Central Health Plan Commercial |
$35.42
|
| Rate for Payer: Cigna of CA HMO |
$31.00
|
| Rate for Payer: Cigna of CA PPO |
$31.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.71
|
| Rate for Payer: Galaxy Health WC |
$37.64
|
| Rate for Payer: Global Benefits Group Commercial |
$26.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.21
|
| Rate for Payer: IEHP medi-cal |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$33.21
|
| Rate for Payer: Networks By Design Commercial |
$22.14
|
| Rate for Payer: Prime Health Services Commercial |
$37.64
|
| Rate for Payer: Riverside University Health MISP |
$17.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.14
|
| Rate for Payer: United Healthcare All Other HMO |
$22.14
|
| Rate for Payer: United Healthcare HMO Rider |
$22.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.64
|
| Rate for Payer: Vantage Medical Group Senior |
$37.64
|
|
|
HC CATH THORACIC 16FR CHEST TUBE
|
Facility
IP
|
$44.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601397
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Blue Shield of California EPN |
$23.65
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Central Health Plan Commercial |
$35.42
|
| Rate for Payer: Cigna of CA HMO |
$31.00
|
| Rate for Payer: Cigna of CA PPO |
$31.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.71
|
| Rate for Payer: Galaxy Health WC |
$37.64
|
| Rate for Payer: Global Benefits Group Commercial |
$26.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$33.21
|
| Rate for Payer: Prime Health Services Commercial |
$37.64
|
|
|
HC CATH THORACIC 20FR CHEST TUBE
|
Facility
IP
|
$44.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601398
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Blue Shield of California EPN |
$23.65
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Central Health Plan Commercial |
$35.42
|
| Rate for Payer: Cigna of CA HMO |
$31.00
|
| Rate for Payer: Cigna of CA PPO |
$31.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.71
|
| Rate for Payer: Galaxy Health WC |
$37.64
|
| Rate for Payer: Global Benefits Group Commercial |
$26.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$33.21
|
| Rate for Payer: Prime Health Services Commercial |
$37.64
|
|
|
HC CATH THORACIC 20FR CHEST TUBE
|
Facility
OP
|
$44.28
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601398
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.66
|
| Rate for Payer: BCBS Transplant Transplant |
$26.57
|
| Rate for Payer: Blue Shield of California Commercial |
$33.21
|
| Rate for Payer: Blue Shield of California EPN |
$24.09
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Central Health Plan Commercial |
$35.42
|
| Rate for Payer: Cigna of CA HMO |
$31.00
|
| Rate for Payer: Cigna of CA PPO |
$31.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.71
|
| Rate for Payer: Galaxy Health WC |
$37.64
|
| Rate for Payer: Global Benefits Group Commercial |
$26.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.21
|
| Rate for Payer: IEHP medi-cal |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.86
|
| Rate for Payer: Multiplan Commercial |
$33.21
|
| Rate for Payer: Networks By Design Commercial |
$22.14
|
| Rate for Payer: Prime Health Services Commercial |
$37.64
|
| Rate for Payer: Riverside University Health MISP |
$17.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.14
|
| Rate for Payer: United Healthcare All Other HMO |
$22.14
|
| Rate for Payer: United Healthcare HMO Rider |
$22.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.64
|
| Rate for Payer: Vantage Medical Group Senior |
$37.64
|
|
|
HC CATH THORACIC 24FR CHEST TUBE
|
Facility
OP
|
$57.32
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$48.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.93
|
| Rate for Payer: BCBS Transplant Transplant |
$34.39
|
| Rate for Payer: Blue Shield of California Commercial |
$42.99
|
| Rate for Payer: Blue Shield of California EPN |
$31.18
|
| Rate for Payer: Cash Price |
$25.79
|
| Rate for Payer: Cash Price |
$25.79
|
| Rate for Payer: Central Health Plan Commercial |
$45.86
|
| Rate for Payer: Cigna of CA HMO |
$40.12
|
| Rate for Payer: Cigna of CA PPO |
$40.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.93
|
| Rate for Payer: Galaxy Health WC |
$48.72
|
| Rate for Payer: Global Benefits Group Commercial |
$34.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.59
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.99
|
| Rate for Payer: IEHP medi-cal |
$20.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.46
|
| Rate for Payer: Multiplan Commercial |
$42.99
|
| Rate for Payer: Networks By Design Commercial |
$28.66
|
| Rate for Payer: Prime Health Services Commercial |
$48.72
|
| Rate for Payer: Riverside University Health MISP |
$22.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.66
|
| Rate for Payer: United Healthcare All Other HMO |
$28.66
|
| Rate for Payer: United Healthcare HMO Rider |
$28.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.72
|
| Rate for Payer: Vantage Medical Group Senior |
$48.72
|
|
|
HC CATH THORACIC 24FR CHEST TUBE
|
Facility
IP
|
$57.32
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$51.59 |
| Rate for Payer: Blue Shield of California EPN |
$30.61
|
| Rate for Payer: Cash Price |
$25.79
|
| Rate for Payer: Central Health Plan Commercial |
$45.86
|
| Rate for Payer: Cigna of CA HMO |
$40.12
|
| Rate for Payer: Cigna of CA PPO |
$40.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.93
|
| Rate for Payer: Galaxy Health WC |
$48.72
|
| Rate for Payer: Global Benefits Group Commercial |
$34.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.46
|
| Rate for Payer: Multiplan Commercial |
$42.99
|
| Rate for Payer: Prime Health Services Commercial |
$48.72
|
|
|
HC CATH THORACIC 28FR CHEST TUBE
|
Facility
OP
|
$56.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$48.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.56
|
| Rate for Payer: BCBS Transplant Transplant |
$34.00
|
| Rate for Payer: Blue Shield of California Commercial |
$42.50
|
| Rate for Payer: Blue Shield of California EPN |
$30.82
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Central Health Plan Commercial |
$45.33
|
| Rate for Payer: Cigna of CA HMO |
$39.66
|
| Rate for Payer: Cigna of CA PPO |
$39.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.66
|
| Rate for Payer: Galaxy Health WC |
$48.16
|
| Rate for Payer: Global Benefits Group Commercial |
$34.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.99
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.50
|
| Rate for Payer: IEHP medi-cal |
$19.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.33
|
| Rate for Payer: Multiplan Commercial |
$42.50
|
| Rate for Payer: Networks By Design Commercial |
$28.33
|
| Rate for Payer: Prime Health Services Commercial |
$48.16
|
| Rate for Payer: Riverside University Health MISP |
$22.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.33
|
| Rate for Payer: United Healthcare All Other HMO |
$28.33
|
| Rate for Payer: United Healthcare HMO Rider |
$28.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.16
|
| Rate for Payer: Vantage Medical Group Senior |
$48.16
|
|
|
HC CATH THORACIC 28FR CHEST TUBE
|
Facility
IP
|
$56.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$50.99 |
| Rate for Payer: Blue Shield of California EPN |
$30.26
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Central Health Plan Commercial |
$45.33
|
| Rate for Payer: Cigna of CA HMO |
$39.66
|
| Rate for Payer: Cigna of CA PPO |
$39.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.66
|
| Rate for Payer: Galaxy Health WC |
$48.16
|
| Rate for Payer: Global Benefits Group Commercial |
$34.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.33
|
| Rate for Payer: Multiplan Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Commercial |
$48.16
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
OP
|
$55.84
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$312.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$47.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$30.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$30.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.10
|
| Rate for Payer: BCBS Transplant Transplant |
$33.50
|
| Rate for Payer: Blue Shield of California Commercial |
$41.88
|
| Rate for Payer: Blue Shield of California EPN |
$30.38
|
| Rate for Payer: Cash Price |
$25.13
|
| Rate for Payer: Cash Price |
$25.13
|
| Rate for Payer: Central Health Plan Commercial |
$44.67
|
| Rate for Payer: Cigna of CA HMO |
$39.09
|
| Rate for Payer: Cigna of CA PPO |
$39.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.34
|
| Rate for Payer: Galaxy Health WC |
$47.46
|
| Rate for Payer: Global Benefits Group Commercial |
$33.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$41.88
|
| Rate for Payer: IEHP medi-cal |
$19.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.17
|
| Rate for Payer: Multiplan Commercial |
$41.88
|
| Rate for Payer: Networks By Design Commercial |
$27.92
|
| Rate for Payer: Prime Health Services Commercial |
$47.46
|
| Rate for Payer: Riverside University Health MISP |
$22.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.92
|
| Rate for Payer: United Healthcare All Other HMO |
$27.92
|
| Rate for Payer: United Healthcare HMO Rider |
$27.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.46
|
| Rate for Payer: Vantage Medical Group Senior |
$47.46
|
|
