|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$64,324.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$875.36 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$40,737.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,438.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,907.85
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$28,945.80
|
| Rate for Payer: Cash Price |
$28,945.80
|
| Rate for Payer: Cash Price |
$28,945.80
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: Cigna of CA HMO |
$41,167.36
|
| Rate for Payer: Cigna of CA PPO |
$47,599.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,995.54
|
| Rate for Payer: EPIC Health Plan Senior |
$40,737.44
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66,809.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$875.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: InnovAge PACE Commercial |
$61,106.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$966.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,737.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,588.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,588.17
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Preferred Health Network WC |
$66,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$43,181.69
|
| Rate for Payer: Prime Health Services WC |
$64,245.53
|
| Rate for Payer: Riverside University Health System MISP |
$44,811.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,594.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$40,737.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$64,324.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,864.80 |
| Max. Negotiated Rate |
$57,891.60 |
| Rate for Payer: Adventist Health Commercial |
$12,864.80
|
| Rate for Payer: Cash Price |
$28,945.80
|
| Rate for Payer: Central Health Plan Commercial |
$51,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,729.60
|
| Rate for Payer: Galaxy Health WC |
$54,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,904.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,507.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,816.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,864.80
|
| Rate for Payer: Multiplan Commercial |
$48,243.00
|
| Rate for Payer: Networks By Design Commercial |
$41,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,675.40
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
OP
|
$9,275.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$473.86 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$1,855.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,602.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,147.14
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,173.75
|
| Rate for Payer: Cash Price |
$4,173.75
|
| Rate for Payer: Cash Price |
$4,173.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,420.00
|
| Rate for Payer: Cigna of CA HMO |
$5,936.00
|
| Rate for Payer: Cigna of CA PPO |
$6,863.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,513.83
|
| Rate for Payer: EPIC Health Plan Senior |
$2,602.84
|
| Rate for Payer: Galaxy Health WC |
$7,883.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,565.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,347.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,268.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$473.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: InnovAge PACE Commercial |
$3,904.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,186.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$523.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,602.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,855.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,487.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,487.81
|
| Rate for Payer: Multiplan Commercial |
$6,956.25
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$6,028.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services Commercial |
$7,883.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,759.01
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Riverside University Health System MISP |
$2,863.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,565.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,602.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
IP
|
$9,275.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,855.00 |
| Max. Negotiated Rate |
$8,347.50 |
| Rate for Payer: Adventist Health Commercial |
$1,855.00
|
| Rate for Payer: Cash Price |
$4,173.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,420.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,710.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,710.00
|
| Rate for Payer: Galaxy Health WC |
$7,883.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,565.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,347.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,186.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,533.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,741.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,855.00
|
| Rate for Payer: Multiplan Commercial |
$6,956.25
|
| Rate for Payer: Networks By Design Commercial |
$6,028.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,883.75
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,352.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$2,116.80 |
| Rate for Payer: Adventist Health Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.80
|
| Rate for Payer: EPIC Health Plan Senior |
$940.80
|
| Rate for Payer: Galaxy Health WC |
$1,999.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,411.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,116.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,568.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$896.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,455.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
| Rate for Payer: Networks By Design Commercial |
$1,528.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,999.20
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,799.10 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,599.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$799.60
|
| Rate for Payer: EPIC Health Plan Senior |
$799.60
|
| Rate for Payer: Galaxy Health WC |
$1,699.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,799.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,333.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$761.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,237.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.80
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: Networks By Design Commercial |
$1,299.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,699.15
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$218.41 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,599.20
|
| Rate for Payer: Cigna of CA HMO |
$1,299.35
|
| Rate for Payer: Cigna of CA PPO |
$1,479.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$1,699.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,799.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$218.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,333.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: Networks By Design Commercial |
$1,299.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,699.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,199.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,199.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,799.10 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,599.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$799.60
|
| Rate for Payer: EPIC Health Plan Senior |
$799.60
|
| Rate for Payer: Galaxy Health WC |
$1,699.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,799.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,333.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$761.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,237.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.80
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: Networks By Design Commercial |
$1,299.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,699.15
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,352.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$218.41 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$470.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,881.60
|
| Rate for Payer: Cigna of CA HMO |
$1,528.80
|
| Rate for Payer: Cigna of CA PPO |
$1,740.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$1,999.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,411.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,116.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$218.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,568.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
| Rate for Payer: Networks By Design Commercial |
$1,528.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,999.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,411.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,411.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$3,237.03 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Cash Price |
$899.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,599.20
|
| Rate for Payer: Cigna of CA HMO |
$1,279.36
|
| Rate for Payer: Cigna of CA PPO |
$1,479.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$1,699.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,199.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,799.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,333.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$1,299.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,699.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,199.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$999.50
|
| Rate for Payer: United Healthcare All Other HMO |
$999.50
|
| Rate for Payer: United Healthcare HMO Rider |
$999.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$999.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$911.70 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$405.20
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$627.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$558.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,003.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$200.60 |
| Max. Negotiated Rate |
$902.70 |
| Rate for Payer: Adventist Health Commercial |
$200.60
|
| Rate for Payer: Cash Price |
$451.35
|
| Rate for Payer: Central Health Plan Commercial |
$802.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$401.20
|
| Rate for Payer: EPIC Health Plan Senior |
$401.20
|
| Rate for Payer: Galaxy Health WC |
$852.55
|
| Rate for Payer: Global Benefits Group Commercial |
$601.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$902.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$669.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$382.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$620.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.60
|
| Rate for Payer: Multiplan Commercial |
$752.25
|
| Rate for Payer: Networks By Design Commercial |
$651.95
|
| Rate for Payer: Prime Health Services Commercial |
$852.55
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$594.93
|
| Rate for Payer: Blue Shield of California Commercial |
$618.94
|
| Rate for Payer: Blue Shield of California EPN |
$404.19
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Cigna of CA HMO |
$648.32
|
| Rate for Payer: Cigna of CA PPO |
$749.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.50
|
| Rate for Payer: United Healthcare All Other HMO |
$506.50
|
| Rate for Payer: United Healthcare HMO Rider |
$506.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$472.73
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$558.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.16
|
| Rate for Payer: Blue Shield of California Commercial |
$704.48
|
| Rate for Payer: Blue Shield of California EPN |
$460.05
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$576.50
|
| Rate for Payer: United Healthcare All Other HMO |
$576.50
|
| Rate for Payer: United Healthcare HMO Rider |
$576.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$576.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$1,037.70 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.20
|
| Rate for Payer: EPIC Health Plan Senior |
$461.20
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$713.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$558.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.16
|
| Rate for Payer: Blue Shield of California Commercial |
$704.48
|
| Rate for Payer: Blue Shield of California EPN |
$460.05
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$576.50
|
| Rate for Payer: United Healthcare All Other HMO |
$576.50
|
| Rate for Payer: United Healthcare HMO Rider |
$576.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$576.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$163.78 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$230.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$558.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.16
|
| Rate for Payer: Blue Shield of California Commercial |
$704.48
|
| Rate for Payer: Blue Shield of California EPN |
$460.05
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Cash Price |
$518.85
|
| Rate for Payer: Central Health Plan Commercial |
$922.40
|
| Rate for Payer: Cigna of CA HMO |
$737.92
|
| Rate for Payer: Cigna of CA PPO |
$853.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$980.05
|
| Rate for Payer: Global Benefits Group Commercial |
$691.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$170.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$769.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$864.75
|
| Rate for Payer: Networks By Design Commercial |
$749.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$980.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$691.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$576.50
|
| Rate for Payer: United Healthcare All Other HMO |
$576.50
|
| Rate for Payer: United Healthcare HMO Rider |
$576.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$576.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
