|
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 |
$50.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.71
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: 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: Dignity Health Media |
$47.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$41.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.28
|
| 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 System 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
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
IP
|
$57.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$51.36 |
| Rate for Payer: Blue Shield of California EPN |
$30.48
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Central Health Plan Commercial |
$45.66
|
| Rate for Payer: Cigna of CA HMO |
$39.95
|
| Rate for Payer: Cigna of CA PPO |
$39.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.83
|
| Rate for Payer: Galaxy Health WC |
$48.51
|
| Rate for Payer: Global Benefits Group Commercial |
$34.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.41
|
| Rate for Payer: Multiplan Commercial |
$42.80
|
| Rate for Payer: Prime Health Services Commercial |
$48.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.55
|
| Rate for Payer: United Healthcare All Other HMO |
$21.05
|
| Rate for Payer: United Healthcare HMO Rider |
$20.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.83
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
OP
|
$57.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$51.36 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.79
|
| Rate for Payer: Blue Distinction Transplant |
$34.24
|
| Rate for Payer: Blue Shield of California Commercial |
$42.80
|
| Rate for Payer: Blue Shield of California EPN |
$31.05
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Central Health Plan Commercial |
$45.66
|
| Rate for Payer: Cigna of CA HMO |
$39.95
|
| Rate for Payer: Cigna of CA PPO |
$39.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.51
|
| Rate for Payer: Dignity Health Media |
$48.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.83
|
| Rate for Payer: Galaxy Health WC |
$48.51
|
| Rate for Payer: Global Benefits Group Commercial |
$34.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.36
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.41
|
| Rate for Payer: Multiplan Commercial |
$42.80
|
| Rate for Payer: Networks By Design Commercial |
$28.54
|
| Rate for Payer: Prime Health Services Commercial |
$48.51
|
| Rate for Payer: Riverside University Health System MISP |
$22.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.54
|
| Rate for Payer: United Healthcare All Other HMO |
$28.54
|
| Rate for Payer: United Healthcare HMO Rider |
$28.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.51
|
| Rate for Payer: Vantage Medical Group Senior |
$48.51
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
IP
|
$40.84
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$36.76 |
| Rate for Payer: Blue Shield of California EPN |
$21.81
|
| Rate for Payer: Cash Price |
$18.38
|
| Rate for Payer: Central Health Plan Commercial |
$32.67
|
| Rate for Payer: Cigna of CA HMO |
$28.59
|
| Rate for Payer: Cigna of CA PPO |
$28.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.34
|
| Rate for Payer: Galaxy Health WC |
$34.71
|
| Rate for Payer: Global Benefits Group Commercial |
$24.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.17
|
| Rate for Payer: Multiplan Commercial |
$30.63
|
| Rate for Payer: Prime Health Services Commercial |
$34.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.42
|
| Rate for Payer: United Healthcare All Other HMO |
$15.06
|
| Rate for Payer: United Healthcare HMO Rider |
$14.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.48
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
OP
|
$40.84
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$36.76 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.75
|
| Rate for Payer: Blue Distinction Transplant |
$24.50
|
| Rate for Payer: Blue Shield of California Commercial |
$30.63
|
| Rate for Payer: Blue Shield of California EPN |
$22.22
|
| Rate for Payer: Cash Price |
$18.38
|
| Rate for Payer: Central Health Plan Commercial |
$32.67
|
| Rate for Payer: Cigna of CA HMO |
$28.59
|
| Rate for Payer: Cigna of CA PPO |
$28.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.71
|
| Rate for Payer: Dignity Health Media |
$34.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.34
|
| Rate for Payer: Galaxy Health WC |
$34.71
|
| Rate for Payer: Global Benefits Group Commercial |
$24.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.17
|
| Rate for Payer: Multiplan Commercial |
$30.63
|
| Rate for Payer: Networks By Design Commercial |
$20.42
|
| Rate for Payer: Prime Health Services Commercial |
$34.71
|
| Rate for Payer: Riverside University Health System MISP |
$16.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.42
|
| Rate for Payer: United Healthcare All Other HMO |
$20.42
|
| Rate for Payer: United Healthcare HMO Rider |
$20.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.71
|
| Rate for Payer: Vantage Medical Group Senior |
$34.71
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
IP
|
$52.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$47.23 |
| Rate for Payer: Blue Shield of California EPN |
$28.02
|
| Rate for Payer: Cash Price |
$23.62
|
| Rate for Payer: Central Health Plan Commercial |
$41.98
|
| Rate for Payer: Cigna of CA HMO |
$36.74
|
| Rate for Payer: Cigna of CA PPO |
$36.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.99
|
| Rate for Payer: Galaxy Health WC |
$44.61
|
| Rate for Payer: Global Benefits Group Commercial |
$31.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: Multiplan Commercial |
$39.36
|
| Rate for Payer: Prime Health Services Commercial |
$44.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.82
|
| Rate for Payer: United Healthcare All Other HMO |
$19.35
|
| Rate for Payer: United Healthcare HMO Rider |
$18.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.32
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
OP
|
$52.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$47.23 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.23
|
| Rate for Payer: Blue Distinction Transplant |
$31.49
|
| Rate for Payer: Blue Shield of California Commercial |
$39.36
|
| Rate for Payer: Blue Shield of California EPN |
$28.55
|
| Rate for Payer: Cash Price |
$23.62
|
| Rate for Payer: Central Health Plan Commercial |
$41.98
|
| Rate for Payer: Cigna of CA HMO |
$36.74
|
| Rate for Payer: Cigna of CA PPO |
$36.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.61
|
| Rate for Payer: Dignity Health Media |
$44.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.99
|
| Rate for Payer: Galaxy Health WC |
$44.61
|
| Rate for Payer: Global Benefits Group Commercial |
$31.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.23
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: Multiplan Commercial |
$39.36
|
| Rate for Payer: Networks By Design Commercial |
$26.24
|
| Rate for Payer: Prime Health Services Commercial |
$44.61
|
| Rate for Payer: Riverside University Health System MISP |
$20.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.24
|
| Rate for Payer: United Healthcare All Other HMO |
$26.24
|
| Rate for Payer: United Healthcare HMO Rider |
$26.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.61
|
| Rate for Payer: Vantage Medical Group Senior |
$44.61
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
IP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Blue Shield of California EPN |
$30.08
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Central Health Plan Commercial |
$45.06
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.27
|
| Rate for Payer: United Healthcare All Other HMO |
$20.77
|
| Rate for Payer: United Healthcare HMO Rider |
$20.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.59
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
OP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.38
|
| Rate for Payer: Blue Distinction Transplant |
$33.80
|
| Rate for Payer: Blue Shield of California Commercial |
$42.25
|
| Rate for Payer: Blue Shield of California EPN |
$30.64
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Central Health Plan Commercial |
$45.06
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.88
|
| Rate for Payer: Dignity Health Media |
$47.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$42.25
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: Riverside University Health System MISP |
$22.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.16
|
| Rate for Payer: United Healthcare All Other HMO |
$28.16
|
| Rate for Payer: United Healthcare HMO Rider |
$28.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.88
|
| Rate for Payer: Vantage Medical Group Senior |
$47.88
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
IP
|
$53.55
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$48.20 |
| Rate for Payer: Blue Shield of California EPN |
$28.60
|
| Rate for Payer: Cash Price |
$24.10
|
| Rate for Payer: Central Health Plan Commercial |
$42.84
|
| Rate for Payer: Cigna of CA HMO |
$37.48
|
| Rate for Payer: Cigna of CA PPO |
$37.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$45.52
|
| Rate for Payer: Global Benefits Group Commercial |
$32.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.71
|
| Rate for Payer: Multiplan Commercial |
$40.16
|
| Rate for Payer: Prime Health Services Commercial |
$45.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.22
|
| Rate for Payer: United Healthcare All Other HMO |
$19.75
|
| Rate for Payer: United Healthcare HMO Rider |
$19.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.67
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
OP
|
$53.55
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$48.20 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.83
|
| Rate for Payer: Blue Distinction Transplant |
$32.13
|
| Rate for Payer: Blue Shield of California Commercial |
$40.16
|
| Rate for Payer: Blue Shield of California EPN |
$29.13
|
| Rate for Payer: Cash Price |
$24.10
|
| Rate for Payer: Central Health Plan Commercial |
$42.84
|
| Rate for Payer: Cigna of CA HMO |
$37.48
|
| Rate for Payer: Cigna of CA PPO |
$37.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.52
|
| Rate for Payer: Dignity Health Media |
$45.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$45.52
|
| Rate for Payer: Global Benefits Group Commercial |
$32.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$40.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.71
|
| Rate for Payer: Multiplan Commercial |
$40.16
|
| Rate for Payer: Networks By Design Commercial |
$26.78
|
| Rate for Payer: Prime Health Services Commercial |
$45.52
|
| Rate for Payer: Riverside University Health System MISP |
$21.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.78
|
| Rate for Payer: United Healthcare All Other HMO |
$26.78
|
| Rate for Payer: United Healthcare HMO Rider |
$26.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.52
|
| Rate for Payer: Vantage Medical Group Senior |
$45.52
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
IP
|
$1,404.15
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.83 |
| Max. Negotiated Rate |
$1,263.74 |
| Rate for Payer: Blue Shield of California EPN |
$749.82
|
| Rate for Payer: Cash Price |
$631.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,123.32
|
| Rate for Payer: Cigna of CA HMO |
$982.90
|
| Rate for Payer: Cigna of CA PPO |
$982.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$561.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$561.66
|
| Rate for Payer: Galaxy Health WC |
$1,193.53
|
| Rate for Payer: Global Benefits Group Commercial |
$842.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,263.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$936.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$534.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.83
|
| Rate for Payer: Multiplan Commercial |
$1,053.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,193.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$530.21
|
| Rate for Payer: United Healthcare All Other HMO |
$517.85
|
| Rate for Payer: United Healthcare HMO Rider |
$506.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$463.37
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
OP
|
$1,404.15
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.83 |
| Max. Negotiated Rate |
$1,263.74 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,193.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$772.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$772.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$641.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$782.11
|
| Rate for Payer: Blue Distinction Transplant |
$842.49
|
| Rate for Payer: Blue Shield of California Commercial |
$1,053.11
|
| Rate for Payer: Blue Shield of California EPN |
$763.86
|
| Rate for Payer: Cash Price |
$631.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,123.32
|
| Rate for Payer: Cigna of CA HMO |
$982.90
|
| Rate for Payer: Cigna of CA PPO |
$982.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,193.53
|
| Rate for Payer: Dignity Health Media |
$1,193.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,193.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$561.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$561.66
|
| Rate for Payer: Galaxy Health WC |
$1,193.53
|
| Rate for Payer: Global Benefits Group Commercial |
$842.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,263.74
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,053.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$491.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$936.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$534.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.83
|
| Rate for Payer: Multiplan Commercial |
$1,053.11
|
| Rate for Payer: Networks By Design Commercial |
$702.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,193.53
|
| Rate for Payer: Riverside University Health System MISP |
$561.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$842.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$842.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$702.08
|
| Rate for Payer: United Healthcare All Other HMO |
$702.08
|
| Rate for Payer: United Healthcare HMO Rider |
$702.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$702.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,193.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,193.53
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
OP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$385.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$349.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$307.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$375.04
|
| Rate for Payer: Blue Distinction Transplant |
$380.88
|
| Rate for Payer: Blue Shield of California Commercial |
$399.29
|
| Rate for Payer: Blue Shield of California EPN |
$310.42
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: Dignity Health Media |
$539.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$476.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Riverside University Health System MISP |
$253.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
IP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$409.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$339.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$414.41
|
| Rate for Payer: Blue Distinction Transplant |
$446.40
|
| Rate for Payer: Blue Shield of California Commercial |
$558.00
|
| Rate for Payer: Blue Shield of California EPN |
$404.74
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.40
|
| Rate for Payer: Dignity Health Media |
$632.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$558.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$260.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Riverside University Health System MISP |
$297.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$372.00
|
| Rate for Payer: United Healthcare All Other HMO |
$372.00
|
| Rate for Payer: United Healthcare HMO Rider |
$372.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$372.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.40
|
| Rate for Payer: Vantage Medical Group Senior |
$632.40
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$669.60 |
| Rate for Payer: Blue Shield of California EPN |
$397.30
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Central Health Plan Commercial |
$595.20
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$669.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.80
|
| Rate for Payer: Multiplan Commercial |
$558.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$280.93
|
| Rate for Payer: United Healthcare All Other HMO |
$274.39
|
| Rate for Payer: United Healthcare HMO Rider |
$268.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$245.52
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,172.30
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,925.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,121.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Media |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,925.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,082.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,472.64
|
| Rate for Payer: United Healthcare All Other HMO |
$1,438.32
|
| Rate for Payer: United Healthcare HMO Rider |
$1,407.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,287.00
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
OP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$774.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$522.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$473.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$416.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$508.21
|
| Rate for Payer: Blue Distinction Transplant |
$516.12
|
| Rate for Payer: Blue Shield of California Commercial |
$541.07
|
| Rate for Payer: Blue Shield of California EPN |
$420.64
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Central Health Plan Commercial |
$688.16
|
| Rate for Payer: Cigna of CA HMO |
$550.53
|
| Rate for Payer: Cigna of CA PPO |
$636.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.17
|
| Rate for Payer: Dignity Health Media |
$731.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.18
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$645.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$301.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.04
|
| Rate for Payer: Multiplan Commercial |
$645.15
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
| Rate for Payer: Riverside University Health System MISP |
$344.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$430.10
|
| Rate for Payer: United Healthcare All Other HMO |
$430.10
|
| Rate for Payer: United Healthcare HMO Rider |
$430.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$430.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Vantage Medical Group Senior |
$731.17
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
IP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$774.18 |
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Central Health Plan Commercial |
$688.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.04
|
| Rate for Payer: Multiplan Commercial |
$645.15
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
IP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
OP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$480.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$383.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$467.44
|
| Rate for Payer: Blue Distinction Transplant |
$474.72
|
| Rate for Payer: Blue Shield of California Commercial |
$497.66
|
| Rate for Payer: Blue Shield of California EPN |
$386.90
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$506.37
|
| Rate for Payer: Cigna of CA PPO |
$585.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Media |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$593.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$276.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Riverside University Health System MISP |
$316.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$395.60
|
| Rate for Payer: United Healthcare All Other HMO |
$395.60
|
| Rate for Payer: United Healthcare HMO Rider |
$395.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
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 TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
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
|
|
