|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
OP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$252.19 |
| Rate for Payer: Adventist Health Commercial |
$56.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$170.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$238.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$210.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.00
|
| Rate for Payer: Blue Shield of California Commercial |
$177.65
|
| Rate for Payer: Blue Shield of California EPN |
$111.80
|
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: Central Health Plan Commercial |
$224.17
|
| Rate for Payer: Cigna of CA HMO |
$179.33
|
| Rate for Payer: Cigna of CA PPO |
$207.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$238.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$238.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: EPIC Health Plan Senior |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$165.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$196.15
|
| Rate for Payer: Multiplan Commercial |
$210.16
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
| Rate for Payer: Riverside University Health System MISP |
$112.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.10
|
| Rate for Payer: United Healthcare All Other HMO |
$140.10
|
| Rate for Payer: United Healthcare HMO Rider |
$140.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$238.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.18
|
| Rate for Payer: Vantage Medical Group Senior |
$238.18
|
|
|
HC KIT IAP MONITOR
|
Facility
|
IP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$458.69 |
| Rate for Payer: Adventist Health Commercial |
$101.93
|
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: Central Health Plan Commercial |
$407.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$356.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: EPIC Health Plan Senior |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$323.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$300.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.93
|
| Rate for Payer: Multiplan Commercial |
$382.24
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
|
|
HC KIT IAP MONITOR
|
Facility
|
OP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$458.69 |
| Rate for Payer: Adventist Health Commercial |
$101.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$309.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$433.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$280.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$382.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$296.46
|
| Rate for Payer: Blue Shield of California Commercial |
$323.12
|
| Rate for Payer: Blue Shield of California EPN |
$203.35
|
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: Central Health Plan Commercial |
$407.72
|
| Rate for Payer: Cigna of CA HMO |
$326.18
|
| Rate for Payer: Cigna of CA PPO |
$377.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$433.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$433.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$433.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$356.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: EPIC Health Plan Senior |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$323.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$185.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$300.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$356.75
|
| Rate for Payer: Multiplan Commercial |
$382.24
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
| Rate for Payer: Riverside University Health System MISP |
$203.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$254.82
|
| Rate for Payer: United Healthcare All Other HMO |
$254.82
|
| Rate for Payer: United Healthcare HMO Rider |
$254.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$433.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$433.20
|
| Rate for Payer: Vantage Medical Group Senior |
$433.20
|
|
|
HC KIT INDR 3.5FR .018IN X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.31
|
| Rate for Payer: Blue Shield of California Commercial |
$192.17
|
| Rate for Payer: Blue Shield of California EPN |
$120.94
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Riverside University Health System MISP |
$121.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INDR 3.5FR .018IN X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 4FR .018IN DIA X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 4FR .018IN DIA X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.31
|
| Rate for Payer: Blue Shield of California Commercial |
$192.17
|
| Rate for Payer: Blue Shield of California EPN |
$120.94
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Riverside University Health System MISP |
$121.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 5FR .018IN DIA X 40CM
|
Facility
|
IP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
|
|
HC KIT INDR WITH GUIDE 5FR .018IN DIA X 40CM
|
Facility
|
OP
|
$303.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.62 |
| Max. Negotiated Rate |
$272.79 |
| Rate for Payer: Adventist Health Commercial |
$60.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$227.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$146.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.31
|
| Rate for Payer: Blue Shield of California Commercial |
$192.17
|
| Rate for Payer: Blue Shield of California EPN |
$120.94
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Cash Price |
$136.40
|
| Rate for Payer: Central Health Plan Commercial |
$242.48
|
| Rate for Payer: Cigna of CA HMO |
$193.98
|
| Rate for Payer: Cigna of CA PPO |
$224.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$257.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$257.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.24
|
| Rate for Payer: EPIC Health Plan Senior |
$121.24
|
| Rate for Payer: Galaxy Health WC |
$257.63
|
| Rate for Payer: Global Benefits Group Commercial |
$181.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$212.17
|
| Rate for Payer: Multiplan Commercial |
$227.32
|
| Rate for Payer: Networks By Design Commercial |
$197.01
|
| Rate for Payer: Prime Health Services Commercial |
$257.63
|
| Rate for Payer: Riverside University Health System MISP |
$121.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.55
|
| Rate for Payer: United Healthcare All Other HMO |
$151.55
|
| Rate for Payer: United Healthcare HMO Rider |
$151.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$257.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$257.63
|
| Rate for Payer: Vantage Medical Group Senior |
$257.63
|
|
|
HC KIT INTRODUCER SHEATH 8.5FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698228
|
|
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 KIT INTRODUCER SHEATH 8.5FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698228
|
|
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 KIT OPTIFLOW OXYGEN COATED
|
Facility
|
IP
|
$248.00
|
|
| Hospital Charge Code |
900800920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Adventist Health Commercial |
$49.60
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.20
|
| Rate for Payer: EPIC Health Plan Senior |
$99.20
|
| Rate for Payer: Galaxy Health WC |
$210.80
|
| Rate for Payer: Global Benefits Group Commercial |
$148.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.60
|
| Rate for Payer: Multiplan Commercial |
$186.00
|
| Rate for Payer: Networks By Design Commercial |
$161.20
|
| Rate for Payer: Prime Health Services Commercial |
$210.80
|
|
|
HC KIT OPTIFLOW OXYGEN COATED
|
Facility
|
OP
|
$248.00
|
|
| Hospital Charge Code |
900800920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Adventist Health Commercial |
$49.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$210.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.26
|
| Rate for Payer: Blue Shield of California Commercial |
$157.23
|
| Rate for Payer: Blue Shield of California EPN |
$98.95
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.40
|
| Rate for Payer: Cigna of CA HMO |
$158.72
|
| Rate for Payer: Cigna of CA PPO |
$183.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$210.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$210.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$210.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.20
|
| Rate for Payer: EPIC Health Plan Senior |
$99.20
|
| Rate for Payer: Galaxy Health WC |
$210.80
|
| Rate for Payer: Global Benefits Group Commercial |
$148.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$90.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$173.60
|
| Rate for Payer: Multiplan Commercial |
$186.00
|
| Rate for Payer: Networks By Design Commercial |
$161.20
|
| Rate for Payer: Prime Health Services Commercial |
$210.80
|
| Rate for Payer: Riverside University Health System MISP |
$99.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.00
|
| Rate for Payer: United Healthcare All Other HMO |
$124.00
|
| Rate for Payer: United Healthcare HMO Rider |
$124.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$210.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$210.80
|
| Rate for Payer: Vantage Medical Group Senior |
$210.80
|
|
|
HC KIT PORT ACCESS DRSNG CHG
|
Facility
|
OP
|
$152.32
|
|
| Hospital Charge Code |
901698925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$137.09 |
| Rate for Payer: Adventist Health Commercial |
$30.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$92.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.60
|
| Rate for Payer: Blue Shield of California Commercial |
$96.57
|
| Rate for Payer: Blue Shield of California EPN |
$60.78
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Central Health Plan Commercial |
$121.86
|
| Rate for Payer: Cigna of CA HMO |
$97.48
|
| Rate for Payer: Cigna of CA PPO |
$112.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$129.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.93
|
| Rate for Payer: EPIC Health Plan Senior |
$60.93
|
| Rate for Payer: Galaxy Health WC |
$129.47
|
| Rate for Payer: Global Benefits Group Commercial |
$91.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$106.62
|
| Rate for Payer: Multiplan Commercial |
$114.24
|
| Rate for Payer: Networks By Design Commercial |
$99.01
|
| Rate for Payer: Prime Health Services Commercial |
$129.47
|
| Rate for Payer: Riverside University Health System MISP |
$60.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.16
|
| Rate for Payer: United Healthcare All Other HMO |
$76.16
|
| Rate for Payer: United Healthcare HMO Rider |
$76.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$129.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.47
|
| Rate for Payer: Vantage Medical Group Senior |
$129.47
|
|
|
HC KIT PORT ACCESS DRSNG CHG
|
Facility
|
IP
|
$152.32
|
|
| Hospital Charge Code |
901698925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$137.09 |
| Rate for Payer: Adventist Health Commercial |
$30.46
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Central Health Plan Commercial |
$121.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.93
|
| Rate for Payer: EPIC Health Plan Senior |
$60.93
|
| Rate for Payer: Galaxy Health WC |
$129.47
|
| Rate for Payer: Global Benefits Group Commercial |
$91.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.46
|
| Rate for Payer: Multiplan Commercial |
$114.24
|
| Rate for Payer: Networks By Design Commercial |
$99.01
|
| Rate for Payer: Prime Health Services Commercial |
$129.47
|
|
|
HC KIT PORT DRSNG CHG
|
Facility
|
OP
|
$22.38
|
|
| Hospital Charge Code |
901698218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$20.14 |
| Rate for Payer: Adventist Health Commercial |
$4.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.02
|
| Rate for Payer: Blue Shield of California Commercial |
$14.19
|
| Rate for Payer: Blue Shield of California EPN |
$8.93
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Central Health Plan Commercial |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$14.32
|
| Rate for Payer: Cigna of CA PPO |
$16.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Senior |
$8.95
|
| Rate for Payer: Galaxy Health WC |
$19.02
|
| Rate for Payer: Global Benefits Group Commercial |
$13.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.67
|
| Rate for Payer: Multiplan Commercial |
$16.79
|
| Rate for Payer: Networks By Design Commercial |
$14.55
|
| Rate for Payer: Prime Health Services Commercial |
$19.02
|
| Rate for Payer: Riverside University Health System MISP |
$8.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.19
|
| Rate for Payer: United Healthcare All Other HMO |
$11.19
|
| Rate for Payer: United Healthcare HMO Rider |
$11.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.02
|
| Rate for Payer: Vantage Medical Group Senior |
$19.02
|
|
|
HC KIT PORT DRSNG CHG
|
Facility
|
IP
|
$22.38
|
|
| Hospital Charge Code |
901698218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$20.14 |
| Rate for Payer: Adventist Health Commercial |
$4.48
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Central Health Plan Commercial |
$17.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Senior |
$8.95
|
| Rate for Payer: Galaxy Health WC |
$19.02
|
| Rate for Payer: Global Benefits Group Commercial |
$13.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.48
|
| Rate for Payer: Multiplan Commercial |
$16.79
|
| Rate for Payer: Networks By Design Commercial |
$14.55
|
| Rate for Payer: Prime Health Services Commercial |
$19.02
|
|
|
HC KIT RESUSCITATION MURRIETA
|
Facility
|
IP
|
$255.64
|
|
| Hospital Charge Code |
901698319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$230.08 |
| Rate for Payer: Adventist Health Commercial |
$51.13
|
| Rate for Payer: Cash Price |
$115.04
|
| Rate for Payer: Central Health Plan Commercial |
$204.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$178.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.26
|
| Rate for Payer: EPIC Health Plan Senior |
$102.26
|
| Rate for Payer: Galaxy Health WC |
$217.29
|
| Rate for Payer: Global Benefits Group Commercial |
$153.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$162.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$150.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.13
|
| Rate for Payer: Multiplan Commercial |
$191.73
|
| Rate for Payer: Networks By Design Commercial |
$166.17
|
| Rate for Payer: Prime Health Services Commercial |
$217.29
|
|
|
HC KIT RESUSCITATION MURRIETA
|
Facility
|
OP
|
$255.64
|
|
| Hospital Charge Code |
901698319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$230.08 |
| Rate for Payer: Adventist Health Commercial |
$51.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$155.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$217.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.71
|
| Rate for Payer: Blue Shield of California Commercial |
$162.08
|
| Rate for Payer: Blue Shield of California EPN |
$102.00
|
| Rate for Payer: Cash Price |
$115.04
|
| Rate for Payer: Central Health Plan Commercial |
$204.51
|
| Rate for Payer: Cigna of CA HMO |
$163.61
|
| Rate for Payer: Cigna of CA PPO |
$189.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$217.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$178.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.26
|
| Rate for Payer: EPIC Health Plan Senior |
$102.26
|
| Rate for Payer: Galaxy Health WC |
$217.29
|
| Rate for Payer: Global Benefits Group Commercial |
$153.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$162.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$92.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$150.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$178.95
|
| Rate for Payer: Multiplan Commercial |
$191.73
|
| Rate for Payer: Networks By Design Commercial |
$166.17
|
| Rate for Payer: Prime Health Services Commercial |
$217.29
|
| Rate for Payer: Riverside University Health System MISP |
$102.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$153.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$153.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$127.82
|
| Rate for Payer: United Healthcare All Other HMO |
$127.82
|
| Rate for Payer: United Healthcare HMO Rider |
$127.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$127.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$217.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$217.29
|
| Rate for Payer: Vantage Medical Group Senior |
$217.29
|
|
|
HC KIT SPECI CATH FEMALE 8FR PVP
|
Facility
|
IP
|
$13.04
|
|
| Hospital Charge Code |
901607395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$11.74 |
| Rate for Payer: Adventist Health Commercial |
$2.61
|
| Rate for Payer: Cash Price |
$5.87
|
| Rate for Payer: Central Health Plan Commercial |
$10.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$11.08
|
| Rate for Payer: Global Benefits Group Commercial |
$7.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.61
|
| Rate for Payer: Multiplan Commercial |
$9.78
|
| Rate for Payer: Networks By Design Commercial |
$8.48
|
| Rate for Payer: Prime Health Services Commercial |
$11.08
|
|
|
HC KIT SPECI CATH FEMALE 8FR PVP
|
Facility
|
OP
|
$13.04
|
|
| Hospital Charge Code |
901607395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$11.74 |
| Rate for Payer: Adventist Health Commercial |
$2.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.59
|
| Rate for Payer: Blue Shield of California Commercial |
$8.27
|
| Rate for Payer: Blue Shield of California EPN |
$5.20
|
| Rate for Payer: Cash Price |
$5.87
|
| Rate for Payer: Central Health Plan Commercial |
$10.43
|
| Rate for Payer: Cigna of CA HMO |
$8.35
|
| Rate for Payer: Cigna of CA PPO |
$9.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$11.08
|
| Rate for Payer: Global Benefits Group Commercial |
$7.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.13
|
| Rate for Payer: Multiplan Commercial |
$9.78
|
| Rate for Payer: Networks By Design Commercial |
$8.48
|
| Rate for Payer: Prime Health Services Commercial |
$11.08
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.52
|
| Rate for Payer: United Healthcare All Other HMO |
$6.52
|
| Rate for Payer: United Healthcare HMO Rider |
$6.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.08
|
| Rate for Payer: Vantage Medical Group Senior |
$11.08
|
|
|
HC KIT TUBE PEG 20FR
|
Facility
|
IP
|
$528.00
|
|
| Hospital Charge Code |
900831709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Senior |
$211.20
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
|
|
HC KIT TUBE PEG 20FR
|
Facility
|
OP
|
$528.00
|
|
| Hospital Charge Code |
900831709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$320.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$396.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$255.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$307.14
|
| Rate for Payer: Blue Shield of California Commercial |
$334.75
|
| Rate for Payer: Blue Shield of California EPN |
$210.67
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: Cigna of CA HMO |
$337.92
|
| Rate for Payer: Cigna of CA PPO |
$390.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Senior |
$211.20
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$369.60
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
| Rate for Payer: Riverside University Health System MISP |
$211.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$264.00
|
| Rate for Payer: United Healthcare All Other HMO |
$264.00
|
| Rate for Payer: United Healthcare HMO Rider |
$264.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$448.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.80
|
| Rate for Payer: Vantage Medical Group Senior |
$448.80
|
|
|
HC KIT TUBE PEG 24FR
|
Facility
|
IP
|
$528.00
|
|
| Hospital Charge Code |
900831710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Senior |
$211.20
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
|
|
HC KIT TUBE PEG 24FR
|
Facility
|
OP
|
$528.00
|
|
| Hospital Charge Code |
900831710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$320.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$396.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$255.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$307.14
|
| Rate for Payer: Blue Shield of California Commercial |
$334.75
|
| Rate for Payer: Blue Shield of California EPN |
$210.67
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: Cigna of CA HMO |
$337.92
|
| Rate for Payer: Cigna of CA PPO |
$390.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Senior |
$211.20
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$311.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$369.60
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
| Rate for Payer: Riverside University Health System MISP |
$211.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$264.00
|
| Rate for Payer: United Healthcare All Other HMO |
$264.00
|
| Rate for Payer: United Healthcare HMO Rider |
$264.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$264.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$448.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.80
|
| Rate for Payer: Vantage Medical Group Senior |
$448.80
|
|
