|
HC CATH UMBILICAL VESSEL 5.0FR
|
Facility
|
OP
|
$206.22
|
|
| Hospital Charge Code |
901603823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.24 |
| Max. Negotiated Rate |
$185.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$175.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$113.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.83
|
| Rate for Payer: Blue Distinction Transplant |
$123.73
|
| Rate for Payer: Blue Shield of California Commercial |
$129.71
|
| Rate for Payer: Blue Shield of California EPN |
$100.84
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Central Health Plan Commercial |
$164.98
|
| Rate for Payer: Cigna of CA HMO |
$131.98
|
| Rate for Payer: Cigna of CA PPO |
$152.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$175.29
|
| Rate for Payer: Dignity Health Media |
$175.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$82.49
|
| Rate for Payer: Galaxy Health WC |
$175.29
|
| Rate for Payer: Global Benefits Group Commercial |
$123.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$185.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$154.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$137.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.24
|
| Rate for Payer: Multiplan Commercial |
$154.66
|
| Rate for Payer: Networks By Design Commercial |
$134.04
|
| Rate for Payer: Prime Health Services Commercial |
$175.29
|
| Rate for Payer: Riverside University Health System MISP |
$82.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$123.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$123.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.11
|
| Rate for Payer: United Healthcare All Other HMO |
$103.11
|
| Rate for Payer: United Healthcare HMO Rider |
$103.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.29
|
| Rate for Payer: Vantage Medical Group Senior |
$175.29
|
|
|
HC CATH URETHRAL 14FR PVC
|
Facility
|
OP
|
$3.53
|
|
| Hospital Charge Code |
901698527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$3.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.09
|
| Rate for Payer: Blue Distinction Transplant |
$2.12
|
| Rate for Payer: Blue Shield of California Commercial |
$2.22
|
| Rate for Payer: Blue Shield of California EPN |
$1.73
|
| Rate for Payer: Cash Price |
$1.59
|
| Rate for Payer: Central Health Plan Commercial |
$2.82
|
| Rate for Payer: Cigna of CA HMO |
$2.26
|
| Rate for Payer: Cigna of CA PPO |
$2.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.00
|
| Rate for Payer: Dignity Health Media |
$3.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.41
|
| Rate for Payer: Galaxy Health WC |
$3.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.18
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.71
|
| Rate for Payer: Multiplan Commercial |
$2.65
|
| Rate for Payer: Networks By Design Commercial |
$2.29
|
| Rate for Payer: Prime Health Services Commercial |
$3.00
|
| Rate for Payer: Riverside University Health System MISP |
$1.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.76
|
| Rate for Payer: United Healthcare All Other HMO |
$1.76
|
| Rate for Payer: United Healthcare HMO Rider |
$1.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3.00
|
|
|
HC CATH URETHRAL 14FR PVC
|
Facility
|
IP
|
$3.53
|
|
| Hospital Charge Code |
901698527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$3.18 |
| Rate for Payer: Cash Price |
$1.59
|
| Rate for Payer: Central Health Plan Commercial |
$2.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.41
|
| Rate for Payer: Galaxy Health WC |
$3.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.71
|
| Rate for Payer: Multiplan Commercial |
$2.65
|
| Rate for Payer: Networks By Design Commercial |
$2.29
|
| Rate for Payer: Prime Health Services Commercial |
$3.00
|
|
|
HC CATH URETHRAL PVP KIT 14FR
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901698633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.21
|
| Rate for Payer: Blue Distinction Transplant |
$12.40
|
| Rate for Payer: Blue Shield of California Commercial |
$13.00
|
| Rate for Payer: Blue Shield of California EPN |
$10.10
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Central Health Plan Commercial |
$16.53
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Media |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.59
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.13
|
| Rate for Payer: Multiplan Commercial |
$15.50
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC CATH URETHRAL PVP KIT 14FR
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901698633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Central Health Plan Commercial |
$16.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.13
|
| Rate for Payer: Multiplan Commercial |
$15.50
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
IP
|
$4.35
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
OP
|
$4.35
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.57
|
| Rate for Payer: Blue Distinction Transplant |
$2.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2.74
|
| Rate for Payer: Blue Shield of California EPN |
$2.13
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$3.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.70
|
| Rate for Payer: Dignity Health Media |
$3.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
| Rate for Payer: Riverside University Health System MISP |
$1.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.18
|
| Rate for Payer: United Healthcare All Other HMO |
$2.18
|
| Rate for Payer: United Healthcare HMO Rider |
$2.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3.70
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 18FR
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 20FR
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
901607556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC CATH URETHRAL REDRUBBER 8FR
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
901607556
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC CATH URETHRAL TRAY 14FR
|
Facility
|
OP
|
$19.35
|
|
| Hospital Charge Code |
901698668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.43
|
| Rate for Payer: Blue Distinction Transplant |
$11.61
|
| Rate for Payer: Blue Shield of California Commercial |
$12.17
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Central Health Plan Commercial |
$15.48
|
| Rate for Payer: Cigna of CA HMO |
$12.38
|
| Rate for Payer: Cigna of CA PPO |
$14.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.45
|
| Rate for Payer: Dignity Health Media |
$16.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.42
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.51
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
| Rate for Payer: Riverside University Health System MISP |
$7.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.68
|
| Rate for Payer: United Healthcare All Other HMO |
$9.68
|
| Rate for Payer: United Healthcare HMO Rider |
$9.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.45
|
| Rate for Payer: Vantage Medical Group Senior |
$16.45
|
|
|
HC CATH URETHRAL TRAY 14FR
|
Facility
|
IP
|
$19.35
|
|
| Hospital Charge Code |
901698668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.42 |
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Central Health Plan Commercial |
$15.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.51
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
|
|
HC CATH URINARY 12FRX16" ADV+
|
Facility
|
OP
|
$21.98
|
|
| Hospital Charge Code |
901602925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.99
|
| Rate for Payer: Blue Distinction Transplant |
$13.19
|
| Rate for Payer: Blue Shield of California Commercial |
$13.83
|
| Rate for Payer: Blue Shield of California EPN |
$10.75
|
| Rate for Payer: Cash Price |
$9.89
|
| Rate for Payer: Central Health Plan Commercial |
$17.58
|
| Rate for Payer: Cigna of CA HMO |
$14.07
|
| Rate for Payer: Cigna of CA PPO |
$16.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.68
|
| Rate for Payer: Dignity Health Media |
$18.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.79
|
| Rate for Payer: Galaxy Health WC |
$18.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.78
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.48
|
| Rate for Payer: Networks By Design Commercial |
$14.29
|
| Rate for Payer: Prime Health Services Commercial |
$18.68
|
| Rate for Payer: Riverside University Health System MISP |
$8.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.99
|
| Rate for Payer: United Healthcare All Other HMO |
$10.99
|
| Rate for Payer: United Healthcare HMO Rider |
$10.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.68
|
| Rate for Payer: Vantage Medical Group Senior |
$18.68
|
|
|
HC CATH URINARY 12FRX16" ADV+
|
Facility
|
IP
|
$21.98
|
|
| Hospital Charge Code |
901602925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Cash Price |
$9.89
|
| Rate for Payer: Central Health Plan Commercial |
$17.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
| Rate for Payer: Galaxy Health WC |
$18.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.48
|
| Rate for Payer: Networks By Design Commercial |
$14.29
|
| Rate for Payer: Prime Health Services Commercial |
$18.68
|
|
|
HC CATH URINARY DRAIN SET 8FR
|
Facility
|
IP
|
$208.53
|
|
| Hospital Charge Code |
901698692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.71 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Central Health Plan Commercial |
$166.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.41
|
| Rate for Payer: Galaxy Health WC |
$177.25
|
| Rate for Payer: Global Benefits Group Commercial |
$125.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$187.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.71
|
| Rate for Payer: Multiplan Commercial |
$156.40
|
| Rate for Payer: Networks By Design Commercial |
$135.54
|
| Rate for Payer: Prime Health Services Commercial |
$177.25
|
|
|
HC CATH URINARY DRAIN SET 8FR
|
Facility
|
OP
|
$208.53
|
|
| Hospital Charge Code |
901698692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.71 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$177.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.20
|
| Rate for Payer: Blue Distinction Transplant |
$125.12
|
| Rate for Payer: Blue Shield of California Commercial |
$131.17
|
| Rate for Payer: Blue Shield of California EPN |
$101.97
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Central Health Plan Commercial |
$166.82
|
| Rate for Payer: Cigna of CA HMO |
$133.46
|
| Rate for Payer: Cigna of CA PPO |
$154.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$177.25
|
| Rate for Payer: Dignity Health Media |
$177.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$177.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$83.41
|
| Rate for Payer: Galaxy Health WC |
$177.25
|
| Rate for Payer: Global Benefits Group Commercial |
$125.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$187.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$156.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.71
|
| Rate for Payer: Multiplan Commercial |
$156.40
|
| Rate for Payer: Networks By Design Commercial |
$135.54
|
| Rate for Payer: Prime Health Services Commercial |
$177.25
|
| Rate for Payer: Riverside University Health System MISP |
$83.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$125.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$125.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$104.26
|
| Rate for Payer: United Healthcare All Other HMO |
$104.26
|
| Rate for Payer: United Healthcare HMO Rider |
$104.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$104.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$177.25
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
|
