|
HC CATH URINARY PEDS 6FR STRGHT
|
Facility
|
OP
|
$75.85
|
|
| Hospital Charge Code |
901603249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$68.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.81
|
| Rate for Payer: Blue Distinction Transplant |
$45.51
|
| Rate for Payer: Blue Shield of California Commercial |
$47.71
|
| Rate for Payer: Blue Shield of California EPN |
$37.09
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Central Health Plan Commercial |
$60.68
|
| Rate for Payer: Cigna of CA HMO |
$48.54
|
| Rate for Payer: Cigna of CA PPO |
$56.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.47
|
| Rate for Payer: Dignity Health Media |
$64.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.34
|
| Rate for Payer: Galaxy Health WC |
$64.47
|
| Rate for Payer: Global Benefits Group Commercial |
$45.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$56.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.17
|
| Rate for Payer: Multiplan Commercial |
$56.89
|
| Rate for Payer: Networks By Design Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Commercial |
$64.47
|
| Rate for Payer: Riverside University Health System MISP |
$30.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$37.92
|
| Rate for Payer: United Healthcare All Other HMO |
$37.92
|
| Rate for Payer: United Healthcare HMO Rider |
$37.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.47
|
| Rate for Payer: Vantage Medical Group Senior |
$64.47
|
|
|
HC CATH URINARY PEDS 6FR STRGHT
|
Facility
|
IP
|
$75.85
|
|
| Hospital Charge Code |
901603249
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$68.26 |
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Central Health Plan Commercial |
$60.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.34
|
| Rate for Payer: Galaxy Health WC |
$64.47
|
| Rate for Payer: Global Benefits Group Commercial |
$45.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.17
|
| Rate for Payer: Multiplan Commercial |
$56.89
|
| Rate for Payer: Networks By Design Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Commercial |
$64.47
|
|
|
HC CATH, URINARY SILASTIC 5FR
|
Facility
|
IP
|
$122.06
|
|
| Hospital Charge Code |
901698448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Central Health Plan Commercial |
$97.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.82
|
| Rate for Payer: Galaxy Health WC |
$103.75
|
| Rate for Payer: Global Benefits Group Commercial |
$73.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$91.54
|
| Rate for Payer: Networks By Design Commercial |
$79.34
|
| Rate for Payer: Prime Health Services Commercial |
$103.75
|
|
|
HC CATH, URINARY SILASTIC 5FR
|
Facility
|
OP
|
$122.06
|
|
| Hospital Charge Code |
901698448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$103.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.11
|
| Rate for Payer: Blue Distinction Transplant |
$73.24
|
| Rate for Payer: Blue Shield of California Commercial |
$76.78
|
| Rate for Payer: Blue Shield of California EPN |
$59.69
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Central Health Plan Commercial |
$97.65
|
| Rate for Payer: Cigna of CA HMO |
$78.12
|
| Rate for Payer: Cigna of CA PPO |
$90.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$103.75
|
| Rate for Payer: Dignity Health Media |
$103.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$103.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$48.82
|
| Rate for Payer: Galaxy Health WC |
$103.75
|
| Rate for Payer: Global Benefits Group Commercial |
$73.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.85
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$91.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$42.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$91.54
|
| Rate for Payer: Networks By Design Commercial |
$79.34
|
| Rate for Payer: Prime Health Services Commercial |
$103.75
|
| Rate for Payer: Riverside University Health System MISP |
$48.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.03
|
| Rate for Payer: United Healthcare All Other HMO |
$61.03
|
| Rate for Payer: United Healthcare HMO Rider |
$61.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$103.75
|
| Rate for Payer: Vantage Medical Group Senior |
$103.75
|
|
|
HC CATH URINARY SYSTEM 10FR
|
Facility
|
IP
|
$21.98
|
|
| Hospital Charge Code |
901602923
|
|
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 SYSTEM 10FR
|
Facility
|
OP
|
$21.98
|
|
| Hospital Charge Code |
901602923
|
|
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 SYSTEM 14FR
|
Facility
|
OP
|
$21.98
|
|
| Hospital Charge Code |
901602924
|
|
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 SYSTEM 14FR
|
Facility
|
IP
|
$21.98
|
|
| Hospital Charge Code |
901602924
|
|
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 SYSTEM 8FR
|
Facility
|
IP
|
$21.73
|
|
| Hospital Charge Code |
901602922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$19.56 |
| Rate for Payer: Cash Price |
$9.78
|
| Rate for Payer: Central Health Plan Commercial |
$17.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.69
|
| Rate for Payer: Galaxy Health WC |
$18.47
|
| Rate for Payer: Global Benefits Group Commercial |
$13.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.35
|
| Rate for Payer: Multiplan Commercial |
$16.30
|
| Rate for Payer: Networks By Design Commercial |
$14.12
|
| Rate for Payer: Prime Health Services Commercial |
$18.47
|
|
|
HC CATH URINARY SYSTEM 8FR
|
Facility
|
OP
|
$21.73
|
|
| Hospital Charge Code |
901602922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$19.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.84
|
| Rate for Payer: Blue Distinction Transplant |
$13.04
|
| Rate for Payer: Blue Shield of California Commercial |
$13.67
|
| Rate for Payer: Blue Shield of California EPN |
$10.63
|
| Rate for Payer: Cash Price |
$9.78
|
| Rate for Payer: Central Health Plan Commercial |
$17.38
|
| Rate for Payer: Cigna of CA HMO |
$13.91
|
| Rate for Payer: Cigna of CA PPO |
$16.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.47
|
| Rate for Payer: Dignity Health Media |
$18.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.69
|
| Rate for Payer: Galaxy Health WC |
$18.47
|
| Rate for Payer: Global Benefits Group Commercial |
$13.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.35
|
| Rate for Payer: Multiplan Commercial |
$16.30
|
| Rate for Payer: Networks By Design Commercial |
$14.12
|
| Rate for Payer: Prime Health Services Commercial |
$18.47
|
| Rate for Payer: Riverside University Health System MISP |
$8.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.86
|
| Rate for Payer: United Healthcare All Other HMO |
$10.86
|
| Rate for Payer: United Healthcare HMO Rider |
$10.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.47
|
| Rate for Payer: Vantage Medical Group Senior |
$18.47
|
|
|
HC CATH VAPRO PLUS 14FR 16 IN
|
Facility
|
OP
|
$19.52
|
|
| Hospital Charge Code |
901607287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.53
|
| Rate for Payer: Blue Distinction Transplant |
$11.71
|
| Rate for Payer: Blue Shield of California Commercial |
$12.28
|
| Rate for Payer: Blue Shield of California EPN |
$9.55
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Central Health Plan Commercial |
$15.62
|
| Rate for Payer: Cigna of CA HMO |
$12.49
|
| Rate for Payer: Cigna of CA PPO |
$14.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.59
|
| Rate for Payer: Dignity Health Media |
$16.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.81
|
| Rate for Payer: Galaxy Health WC |
$16.59
|
| Rate for Payer: Global Benefits Group Commercial |
$11.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.57
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Multiplan Commercial |
$14.64
|
| Rate for Payer: Networks By Design Commercial |
$12.69
|
| Rate for Payer: Prime Health Services Commercial |
$16.59
|
| Rate for Payer: Riverside University Health System MISP |
$7.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$16.59
|
|
|
HC CATH VAPRO PLUS 14FR 16 IN
|
Facility
|
IP
|
$19.52
|
|
| Hospital Charge Code |
901607287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Central Health Plan Commercial |
$15.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.81
|
| Rate for Payer: Galaxy Health WC |
$16.59
|
| Rate for Payer: Global Benefits Group Commercial |
$11.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Multiplan Commercial |
$14.64
|
| Rate for Payer: Networks By Design Commercial |
$12.69
|
| Rate for Payer: Prime Health Services Commercial |
$16.59
|
|
|
HC CATH VAPRO PLUS 14FR 16IN
|
Facility
|
IP
|
$17.30
|
|
| Hospital Charge Code |
901698330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$15.57 |
| Rate for Payer: Cash Price |
$7.79
|
| Rate for Payer: Central Health Plan Commercial |
$13.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.92
|
| Rate for Payer: Galaxy Health WC |
$14.70
|
| Rate for Payer: Global Benefits Group Commercial |
$10.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.46
|
| Rate for Payer: Multiplan Commercial |
$12.98
|
| Rate for Payer: Networks By Design Commercial |
$11.24
|
| Rate for Payer: Prime Health Services Commercial |
$14.70
|
|
|
HC CATH VAPRO PLUS 14FR 16IN
|
Facility
|
OP
|
$17.30
|
|
| Hospital Charge Code |
901698330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$15.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.22
|
| Rate for Payer: Blue Distinction Transplant |
$10.38
|
| Rate for Payer: Blue Shield of California Commercial |
$10.88
|
| Rate for Payer: Blue Shield of California EPN |
$8.46
|
| Rate for Payer: Cash Price |
$7.79
|
| Rate for Payer: Central Health Plan Commercial |
$13.84
|
| Rate for Payer: Cigna of CA HMO |
$11.07
|
| Rate for Payer: Cigna of CA PPO |
$12.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.70
|
| Rate for Payer: Dignity Health Media |
$14.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.92
|
| Rate for Payer: Galaxy Health WC |
$14.70
|
| Rate for Payer: Global Benefits Group Commercial |
$10.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.57
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.46
|
| Rate for Payer: Multiplan Commercial |
$12.98
|
| Rate for Payer: Networks By Design Commercial |
$11.24
|
| Rate for Payer: Prime Health Services Commercial |
$14.70
|
| Rate for Payer: Riverside University Health System MISP |
$6.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.65
|
| Rate for Payer: United Healthcare All Other HMO |
$8.65
|
| Rate for Payer: United Healthcare HMO Rider |
$8.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.70
|
| Rate for Payer: Vantage Medical Group Senior |
$14.70
|
|
|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$533.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$504.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$326.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$350.34
|
| Rate for Payer: Blue Distinction Transplant |
$355.80
|
| Rate for Payer: Blue Shield of California Commercial |
$373.00
|
| Rate for Payer: Blue Shield of California EPN |
$289.98
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Central Health Plan Commercial |
$474.40
|
| Rate for Payer: Cigna of CA HMO |
$379.52
|
| Rate for Payer: Cigna of CA PPO |
$438.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.05
|
| Rate for Payer: Dignity Health Media |
$504.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$533.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$444.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$207.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$395.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.60
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
| Rate for Payer: Riverside University Health System MISP |
$237.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$355.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$355.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.50
|
| Rate for Payer: United Healthcare All Other HMO |
$296.50
|
| Rate for Payer: United Healthcare HMO Rider |
$296.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.05
|
| Rate for Payer: Vantage Medical Group Senior |
$504.05
|
|
|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$533.70 |
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Central Health Plan Commercial |
$474.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$533.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$395.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.60
|
| Rate for Payer: Multiplan Commercial |
$444.75
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$442.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$389.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$475.59
|
| Rate for Payer: Blue Distinction Transplant |
$483.00
|
| Rate for Payer: Blue Shield of California Commercial |
$506.34
|
| Rate for Payer: Blue Shield of California EPN |
$393.64
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Media |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$603.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$281.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$402.50
|
| Rate for Payer: United Healthcare All Other HMO |
$402.50
|
| Rate for Payer: United Healthcare HMO Rider |
$402.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$402.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
IP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
OP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$1,345.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$822.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$822.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$723.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$883.25
|
| Rate for Payer: Blue Distinction Transplant |
$897.00
|
| Rate for Payer: Blue Shield of California Commercial |
$940.36
|
| Rate for Payer: Blue Shield of California EPN |
$731.06
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Cigna of CA HMO |
$956.80
|
| Rate for Payer: Cigna of CA PPO |
$1,106.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Dignity Health Media |
$1,270.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,270.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,345.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,121.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$523.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$1,121.25
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
| Rate for Payer: Riverside University Health System MISP |
$598.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$747.50
|
| Rate for Payer: United Healthcare All Other HMO |
$747.50
|
| Rate for Payer: United Healthcare HMO Rider |
$747.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$747.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,270.75
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
OP
|
$2,219.09
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$443.82 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,347.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,886.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,220.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,220.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,074.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,311.04
|
| Rate for Payer: Blue Distinction Transplant |
$1,331.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,395.81
|
| Rate for Payer: Blue Shield of California EPN |
$1,085.14
|
| Rate for Payer: Cash Price |
$998.59
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.27
|
| Rate for Payer: Cigna of CA HMO |
$1,420.22
|
| Rate for Payer: Cigna of CA PPO |
$1,642.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,886.23
|
| Rate for Payer: Dignity Health Media |
$1,886.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,886.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$887.64
|
| Rate for Payer: Galaxy Health WC |
$1,886.23
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.18
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,664.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$776.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$845.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.82
|
| Rate for Payer: Multiplan Commercial |
$1,664.32
|
| Rate for Payer: Networks By Design Commercial |
$1,442.41
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.23
|
| Rate for Payer: Riverside University Health System MISP |
$887.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,331.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,331.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,109.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,109.54
|
| Rate for Payer: United Healthcare HMO Rider |
$1,109.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,109.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,886.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1,886.23
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
IP
|
$2,219.09
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$443.82 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Cash Price |
$998.59
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.64
|
| Rate for Payer: Galaxy Health WC |
$1,886.23
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$845.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.82
|
| Rate for Payer: Multiplan Commercial |
$1,664.32
|
| Rate for Payer: Networks By Design Commercial |
$1,442.41
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.23
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
OP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$498.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$451.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$451.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.21
|
| Rate for Payer: Blue Distinction Transplant |
$492.77
|
| Rate for Payer: Blue Shield of California Commercial |
$516.59
|
| Rate for Payer: Blue Shield of California EPN |
$401.61
|
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: Cigna of CA HMO |
$525.62
|
| Rate for Payer: Cigna of CA PPO |
$607.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.09
|
| Rate for Payer: Dignity Health Media |
$698.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$615.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$287.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
| Rate for Payer: Riverside University Health System MISP |
$328.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$492.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$492.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$410.64
|
| Rate for Payer: United Healthcare All Other HMO |
$410.64
|
| Rate for Payer: United Healthcare HMO Rider |
$410.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$410.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.09
|
| Rate for Payer: Vantage Medical Group Senior |
$698.09
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
IP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: Central Health Plan Commercial |
$657.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.26
|
| Rate for Payer: Multiplan Commercial |
$615.96
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,265.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,358.84
|
| Rate for Payer: Blue Distinction Transplant |
$1,380.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,446.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,124.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Media |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,725.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
