|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$771.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$699.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
|
|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$826.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Cigna of CA HMO |
$705.28
|
| Rate for Payer: Cigna of CA PPO |
$815.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$936.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$936.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$936.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$771.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$699.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$771.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
| Rate for Payer: Riverside University Health System MISP |
$440.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$551.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$936.70
|
| Rate for Payer: Vantage Medical Group Senior |
$936.70
|
|
|
HC INTRODUCER 3FR TEARAWAY
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
901200493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
|
HC INTRODUCER 3FR TEARAWAY
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
901200493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.44
|
| Rate for Payer: Blue Shield of California Commercial |
$53.89
|
| Rate for Payer: Blue Shield of California EPN |
$33.91
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$59.50
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Riverside University Health System MISP |
$34.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.50
|
| Rate for Payer: United Healthcare All Other HMO |
$42.50
|
| Rate for Payer: United Healthcare HMO Rider |
$42.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.25
|
| Rate for Payer: Vantage Medical Group Senior |
$72.25
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
OP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.27
|
| Rate for Payer: Blue Shield of California Commercial |
$48.25
|
| Rate for Payer: Blue Shield of California EPN |
$30.36
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: Cigna of CA HMO |
$48.70
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$53.27
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
| Rate for Payer: Riverside University Health System MISP |
$30.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.05
|
| Rate for Payer: United Healthcare All Other HMO |
$38.05
|
| Rate for Payer: United Healthcare HMO Rider |
$38.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.69
|
| Rate for Payer: Vantage Medical Group Senior |
$64.69
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
IP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$68.49 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$295.80 |
| Max. Negotiated Rate |
$1,331.10 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,035.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$939.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$872.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,109.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Cigna of CA HMO |
$946.56
|
| Rate for Payer: Cigna of CA PPO |
$1,094.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,257.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,257.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,035.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$939.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$872.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,035.30
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
| Rate for Payer: Riverside University Health System MISP |
$591.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$887.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$739.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.80 |
| Max. Negotiated Rate |
$1,331.10 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,035.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$939.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$872.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,109.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Cigna of CA HMO |
$946.56
|
| Rate for Payer: Cigna of CA PPO |
$1,094.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,257.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,257.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,035.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$939.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$872.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,035.30
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
| Rate for Payer: Riverside University Health System MISP |
$591.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$887.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$739.50
|
| Rate for Payer: United Healthcare All Other HMO |
$739.50
|
| Rate for Payer: United Healthcare HMO Rider |
$739.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$739.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,257.15
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.95
|
| Rate for Payer: Blue Shield of California Commercial |
$84.96
|
| Rate for Payer: Blue Shield of California EPN |
$53.47
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Riverside University Health System MISP |
$53.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67.00
|
| Rate for Payer: United Healthcare HMO Rider |
$67.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
OP
|
$369.58
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$332.62 |
| Rate for Payer: Adventist Health Commercial |
$73.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$314.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$178.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.98
|
| Rate for Payer: Blue Shield of California Commercial |
$234.31
|
| Rate for Payer: Blue Shield of California EPN |
$147.46
|
| Rate for Payer: Cash Price |
$166.31
|
| Rate for Payer: Cash Price |
$166.31
|
| Rate for Payer: Central Health Plan Commercial |
$295.66
|
| Rate for Payer: Cigna of CA HMO |
$236.53
|
| Rate for Payer: Cigna of CA PPO |
$273.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$314.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$258.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.83
|
| Rate for Payer: EPIC Health Plan Senior |
$147.83
|
| Rate for Payer: Galaxy Health WC |
$314.14
|
| Rate for Payer: Global Benefits Group Commercial |
$221.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$234.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$218.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$258.71
|
| Rate for Payer: Multiplan Commercial |
$277.19
|
| Rate for Payer: Networks By Design Commercial |
$240.23
|
| Rate for Payer: Prime Health Services Commercial |
$314.14
|
| Rate for Payer: Riverside University Health System MISP |
$147.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$221.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$221.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$184.79
|
| Rate for Payer: United Healthcare All Other HMO |
$184.79
|
| Rate for Payer: United Healthcare HMO Rider |
$184.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$184.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.14
|
| Rate for Payer: Vantage Medical Group Senior |
$314.14
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
IP
|
$369.58
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$332.62 |
| Rate for Payer: Adventist Health Commercial |
$73.92
|
| Rate for Payer: Cash Price |
$166.31
|
| Rate for Payer: Central Health Plan Commercial |
$295.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$258.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.83
|
| Rate for Payer: EPIC Health Plan Senior |
$147.83
|
| Rate for Payer: Galaxy Health WC |
$314.14
|
| Rate for Payer: Global Benefits Group Commercial |
$221.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$234.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$218.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.92
|
| Rate for Payer: Multiplan Commercial |
$277.19
|
| Rate for Payer: Networks By Design Commercial |
$240.23
|
| Rate for Payer: Prime Health Services Commercial |
$314.14
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$145.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.09
|
| Rate for Payer: Blue Shield of California Commercial |
$190.83
|
| Rate for Payer: Blue Shield of California EPN |
$120.10
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$210.70
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Riverside University Health System MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.50
|
| Rate for Payer: United Healthcare All Other HMO |
$150.50
|
| Rate for Payer: United Healthcare HMO Rider |
$150.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
IP
|
$310.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.02 |
| Max. Negotiated Rate |
$279.09 |
| Rate for Payer: Adventist Health Commercial |
$62.02
|
| Rate for Payer: Cash Price |
$139.55
|
| Rate for Payer: Central Health Plan Commercial |
$248.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$217.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.04
|
| Rate for Payer: EPIC Health Plan Senior |
$124.04
|
| Rate for Payer: Galaxy Health WC |
$263.58
|
| Rate for Payer: Global Benefits Group Commercial |
$186.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$196.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.02
|
| Rate for Payer: Multiplan Commercial |
$232.57
|
| Rate for Payer: Networks By Design Commercial |
$201.56
|
| Rate for Payer: Prime Health Services Commercial |
$263.58
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
OP
|
$310.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.02 |
| Max. Negotiated Rate |
$279.09 |
| Rate for Payer: Adventist Health Commercial |
$62.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$263.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$170.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$232.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$150.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$180.39
|
| Rate for Payer: Blue Shield of California Commercial |
$196.60
|
| Rate for Payer: Blue Shield of California EPN |
$123.73
|
| Rate for Payer: Cash Price |
$139.55
|
| Rate for Payer: Cash Price |
$139.55
|
| Rate for Payer: Central Health Plan Commercial |
$248.08
|
| Rate for Payer: Cigna of CA HMO |
$198.46
|
| Rate for Payer: Cigna of CA PPO |
$229.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$263.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$263.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$263.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$217.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.04
|
| Rate for Payer: EPIC Health Plan Senior |
$124.04
|
| Rate for Payer: Galaxy Health WC |
$263.58
|
| Rate for Payer: Global Benefits Group Commercial |
$186.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$196.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$112.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$217.07
|
| Rate for Payer: Multiplan Commercial |
$232.57
|
| Rate for Payer: Networks By Design Commercial |
$201.56
|
| Rate for Payer: Prime Health Services Commercial |
$263.58
|
| Rate for Payer: Riverside University Health System MISP |
$124.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$186.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$186.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.05
|
| Rate for Payer: United Healthcare All Other HMO |
$155.05
|
| Rate for Payer: United Healthcare HMO Rider |
$155.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$155.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$263.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$263.58
|
| Rate for Payer: Vantage Medical Group Senior |
$263.58
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
OP
|
$447.18
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.44 |
| Max. Negotiated Rate |
$402.46 |
| Rate for Payer: Adventist Health Commercial |
$89.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$380.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$245.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$216.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.12
|
| Rate for Payer: Blue Shield of California Commercial |
$283.51
|
| Rate for Payer: Blue Shield of California EPN |
$178.42
|
| Rate for Payer: Cash Price |
$201.23
|
| Rate for Payer: Cash Price |
$201.23
|
| Rate for Payer: Central Health Plan Commercial |
$357.74
|
| Rate for Payer: Cigna of CA HMO |
$286.20
|
| Rate for Payer: Cigna of CA PPO |
$330.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$380.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$380.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$380.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$313.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.87
|
| Rate for Payer: EPIC Health Plan Senior |
$178.87
|
| Rate for Payer: Galaxy Health WC |
$380.10
|
| Rate for Payer: Global Benefits Group Commercial |
$268.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$313.03
|
| Rate for Payer: Multiplan Commercial |
$335.38
|
| Rate for Payer: Networks By Design Commercial |
$290.67
|
| Rate for Payer: Prime Health Services Commercial |
$380.10
|
| Rate for Payer: Riverside University Health System MISP |
$178.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$268.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$268.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$223.59
|
| Rate for Payer: United Healthcare All Other HMO |
$223.59
|
| Rate for Payer: United Healthcare HMO Rider |
$223.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$380.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$380.10
|
| Rate for Payer: Vantage Medical Group Senior |
$380.10
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
IP
|
$447.18
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.44 |
| Max. Negotiated Rate |
$402.46 |
| Rate for Payer: Adventist Health Commercial |
$89.44
|
| Rate for Payer: Cash Price |
$201.23
|
| Rate for Payer: Central Health Plan Commercial |
$357.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$313.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.87
|
| Rate for Payer: EPIC Health Plan Senior |
$178.87
|
| Rate for Payer: Galaxy Health WC |
$380.10
|
| Rate for Payer: Global Benefits Group Commercial |
$268.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.44
|
| Rate for Payer: Multiplan Commercial |
$335.38
|
| Rate for Payer: Networks By Design Commercial |
$290.67
|
| Rate for Payer: Prime Health Services Commercial |
$380.10
|
|
|
HC INTRO SHEATH 5FR
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901603290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.20
|
| Rate for Payer: Blue Shield of California Commercial |
$35.09
|
| Rate for Payer: Blue Shield of California EPN |
$22.08
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$38.74
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
