|
HC INTRO CATH DIALYSIS CIRCUIT
|
Facility
|
OP
|
$1,952.00
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
909036901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.40 |
| Max. Negotiated Rate |
$11,238.00 |
| Rate for Payer: Adventist Health Commercial |
$390.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,561.60
|
| Rate for Payer: Cigna of CA HMO |
$1,249.28
|
| Rate for Payer: Cigna of CA PPO |
$1,444.48
|
| 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 |
$1,659.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,171.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,756.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$891.37
|
| 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 |
$1,301.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$984.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.40
|
| 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 |
$1,464.00
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$1,268.80
|
| 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 |
$1,659.20
|
| 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 |
$1,171.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| 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 INTRO CATH DIALYSIS CIRCUIT
|
Facility
|
OP
|
$2,297.00
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
906820280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$459.40 |
| Max. Negotiated Rate |
$11,238.00 |
| Rate for Payer: Adventist Health Commercial |
$459.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$1,033.65
|
| Rate for Payer: Cash Price |
$1,033.65
|
| Rate for Payer: Cash Price |
$1,033.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,837.60
|
| Rate for Payer: Cigna of CA HMO |
$1,470.08
|
| Rate for Payer: Cigna of CA PPO |
$1,699.78
|
| 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 |
$1,952.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,378.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,067.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$891.37
|
| 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 |
$1,532.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$984.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.40
|
| 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 |
$1,722.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$1,493.05
|
| 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 |
$1,952.45
|
| 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 |
$1,378.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| 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 INTRO CATH DIALYSIS CIRCUIT
|
Facility
|
IP
|
$1,952.00
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
909036901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.40 |
| Max. Negotiated Rate |
$1,756.80 |
| Rate for Payer: Adventist Health Commercial |
$390.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,561.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$780.80
|
| Rate for Payer: EPIC Health Plan Senior |
$780.80
|
| Rate for Payer: Galaxy Health WC |
$1,659.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,171.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,756.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,301.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$743.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,208.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.40
|
| Rate for Payer: Multiplan Commercial |
$1,464.00
|
| Rate for Payer: Networks By Design Commercial |
$1,268.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,659.20
|
|
|
HC INTRO CATH RHRT/ MAIN PULM ART
|
Facility
|
OP
|
$472.00
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
909081311
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$94.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$259.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$228.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$277.21
|
| 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 |
$212.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Central Health Plan Commercial |
$377.60
|
| Rate for Payer: Cigna of CA HMO |
$302.08
|
| Rate for Payer: Cigna of CA PPO |
$349.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$401.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$401.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$188.80
|
| Rate for Payer: EPIC Health Plan Senior |
$188.80
|
| Rate for Payer: Galaxy Health WC |
$401.20
|
| Rate for Payer: Global Benefits Group Commercial |
$283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$424.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$138.96
|
| Rate for Payer: InnovAge PACE Commercial |
$236.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$314.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$330.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$330.40
|
| Rate for Payer: Multiplan Commercial |
$354.00
|
| Rate for Payer: Networks By Design Commercial |
$306.80
|
| Rate for Payer: Prime Health Services Commercial |
$401.20
|
| Rate for Payer: Riverside University Health System MISP |
$188.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.20
|
| 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: Vantage Medical Group Commercial/Exchange |
$401.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$401.20
|
| Rate for Payer: Vantage Medical Group Senior |
$401.20
|
|
|
HC INTRO CATH RHRT/ MAIN PULM ART
|
Facility
|
IP
|
$472.00
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
909081311
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$424.80 |
| Rate for Payer: Adventist Health Commercial |
$94.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Central Health Plan Commercial |
$377.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$188.80
|
| Rate for Payer: EPIC Health Plan Senior |
$188.80
|
| Rate for Payer: Galaxy Health WC |
$401.20
|
| Rate for Payer: Global Benefits Group Commercial |
$283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$424.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$314.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$179.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.40
|
| Rate for Payer: Multiplan Commercial |
$354.00
|
| Rate for Payer: Networks By Design Commercial |
$306.80
|
| Rate for Payer: Prime Health Services Commercial |
$401.20
|
|
|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$826.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$533.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$647.20
|
| 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 |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Cigna of CA HMO |
$705.28
|
| Rate for Payer: Cigna of CA PPO |
$815.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$936.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$936.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$936.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: InnovAge PACE Commercial |
$551.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$771.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$771.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
| Rate for Payer: Riverside University Health System MISP |
$440.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$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: Vantage Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$936.70
|
| Rate for Payer: Vantage Medical Group Senior |
$936.70
|
|
|
HC INTRO CATH SUP/INF VENA CAVA
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
909081308
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Adventist Health Commercial |
$220.40
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Senior |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$682.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
|
|
HC INTRODUCER 3FR TEARAWAY
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
901200493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.92
|
| Rate for Payer: Blue Shield of California Commercial |
$51.94
|
| Rate for Payer: Blue Shield of California EPN |
$33.91
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.02
|
| Rate for Payer: InnovAge PACE Commercial |
$42.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.50
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Riverside University Health System MISP |
$34.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.50
|
| Rate for Payer: United Healthcare All Other HMO |
$42.50
|
| Rate for Payer: United Healthcare HMO Rider |
$42.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.25
|
| Rate for Payer: Vantage Medical Group Senior |
$72.25
|
|
|
HC INTRODUCER 3FR TEARAWAY
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT Z7610
|
| Hospital Charge Code |
901200493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.16
|
| Rate for Payer: Blue Shield of California Commercial |
$50.10
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: InnovAge PACE Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC INTRO ET ANGLED 15FR 70CM
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901605097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
OP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$68.49 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.69
|
| Rate for Payer: Blue Shield of California Commercial |
$46.50
|
| Rate for Payer: Blue Shield of California EPN |
$30.36
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: Cigna of CA HMO |
$48.70
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: InnovAge PACE Commercial |
$38.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.27
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
| Rate for Payer: Riverside University Health System MISP |
$30.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.05
|
| Rate for Payer: United Healthcare All Other HMO |
$38.05
|
| Rate for Payer: United Healthcare HMO Rider |
$38.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.69
|
| Rate for Payer: Vantage Medical Group Senior |
$64.69
|
|
|
HC INTRO ETT 15FR 70CM FLEXGDE
|
Facility
|
IP
|
$76.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901691012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$68.49 |
| Rate for Payer: Adventist Health Commercial |
$15.22
|
| Rate for Payer: Cash Price |
$34.24
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.69
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.47
|
| Rate for Payer: Prime Health Services Commercial |
$64.69
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,740.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
906820183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$957.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,305.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$842.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,021.90
|
| 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 |
$783.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: Cigna of CA HMO |
$1,113.60
|
| Rate for Payer: Cigna of CA PPO |
$1,287.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,479.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,479.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: InnovAge PACE Commercial |
$870.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,218.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,218.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$1,131.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: Riverside University Health System MISP |
$696.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,479.00
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$295.80 |
| Max. Negotiated Rate |
$1,331.10 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$986.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$915.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,109.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$716.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$868.62
|
| 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 |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Cigna of CA HMO |
$946.56
|
| Rate for Payer: Cigna of CA PPO |
$1,094.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,257.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,257.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$145.36
|
| Rate for Payer: InnovAge PACE Commercial |
$739.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$986.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$915.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,035.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,035.30
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
| Rate for Payer: Riverside University Health System MISP |
$591.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$887.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$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: Vantage Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.80 |
| Max. Negotiated Rate |
$1,331.10 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$986.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$915.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
IP
|
$1,740.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
906820183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,566.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,160.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,077.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$1,131.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
|
|
HC INTRO NEEDLE OR INTRACATH EXTREMITY ARTERY
|
Facility
|
OP
|
$1,479.00
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
909081371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$295.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,109.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Cash Price |
$665.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,183.20
|
| Rate for Payer: Cigna of CA HMO |
$946.56
|
| Rate for Payer: Cigna of CA PPO |
$1,094.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,257.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,257.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$591.60
|
| Rate for Payer: EPIC Health Plan Senior |
$591.60
|
| Rate for Payer: Galaxy Health WC |
$1,257.15
|
| Rate for Payer: Global Benefits Group Commercial |
$887.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,331.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$739.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$986.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$915.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$295.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,035.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,035.30
|
| Rate for Payer: Multiplan Commercial |
$1,109.25
|
| Rate for Payer: Networks By Design Commercial |
$961.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,257.15
|
| Rate for Payer: Riverside University Health System MISP |
$591.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$887.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$739.50
|
| Rate for Payer: United Healthcare All Other HMO |
$739.50
|
| Rate for Payer: United Healthcare HMO Rider |
$739.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$739.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,257.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,257.15
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC INTRO PERCUTANEOUS 7FR
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.70
|
| Rate for Payer: Blue Shield of California Commercial |
$81.87
|
| Rate for Payer: Blue Shield of California EPN |
$53.47
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: InnovAge PACE Commercial |
$67.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Riverside University Health System MISP |
$53.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67.00
|
| Rate for Payer: United Healthcare HMO Rider |
$67.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
IP
|
$369.58
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$332.62 |
| Rate for Payer: Adventist Health Commercial |
$73.92
|
| Rate for Payer: Cash Price |
$166.31
|
| Rate for Payer: Central Health Plan Commercial |
$295.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.83
|
| Rate for Payer: EPIC Health Plan Senior |
$147.83
|
| Rate for Payer: Galaxy Health WC |
$314.14
|
| Rate for Payer: Global Benefits Group Commercial |
$221.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.92
|
| Rate for Payer: Multiplan Commercial |
$277.19
|
| Rate for Payer: Networks By Design Commercial |
$240.23
|
| Rate for Payer: Prime Health Services Commercial |
$314.14
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
OP
|
$369.58
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$332.62 |
| Rate for Payer: Adventist Health Commercial |
$73.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$224.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$314.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$178.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.05
|
| Rate for Payer: Blue Shield of California Commercial |
$225.81
|
| Rate for Payer: Blue Shield of California EPN |
$147.46
|
| Rate for Payer: Cash Price |
$166.31
|
| Rate for Payer: Central Health Plan Commercial |
$295.66
|
| Rate for Payer: Cigna of CA HMO |
$236.53
|
| Rate for Payer: Cigna of CA PPO |
$273.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$314.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.83
|
| Rate for Payer: EPIC Health Plan Senior |
$147.83
|
| Rate for Payer: Galaxy Health WC |
$314.14
|
| Rate for Payer: Global Benefits Group Commercial |
$221.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$332.62
|
| Rate for Payer: InnovAge PACE Commercial |
$184.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$228.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$258.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$258.71
|
| Rate for Payer: Multiplan Commercial |
$277.19
|
| Rate for Payer: Networks By Design Commercial |
$240.23
|
| Rate for Payer: Prime Health Services Commercial |
$314.14
|
| Rate for Payer: Riverside University Health System MISP |
$147.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$221.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$221.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$184.79
|
| Rate for Payer: United Healthcare All Other HMO |
$184.79
|
| Rate for Payer: United Healthcare HMO Rider |
$184.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$184.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.14
|
| Rate for Payer: Vantage Medical Group Senior |
$314.14
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC INTRO PICC SHEATH 1.9FR
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$182.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$145.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.78
|
| Rate for Payer: Blue Shield of California Commercial |
$183.91
|
| Rate for Payer: Blue Shield of California EPN |
$120.10
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: InnovAge PACE Commercial |
$150.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$210.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$210.70
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Riverside University Health System MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.50
|
| Rate for Payer: United Healthcare All Other HMO |
$150.50
|
| Rate for Payer: United Healthcare HMO Rider |
$150.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
