|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
OP
|
$310.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.02 |
| Max. Negotiated Rate |
$279.09 |
| Rate for Payer: Adventist Health Commercial |
$62.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$263.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$170.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$232.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$150.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$182.12
|
| Rate for Payer: Blue Shield of California Commercial |
$189.47
|
| Rate for Payer: Blue Shield of California EPN |
$123.73
|
| Rate for Payer: Cash Price |
$139.55
|
| Rate for Payer: Central Health Plan Commercial |
$248.08
|
| Rate for Payer: Cigna of CA HMO |
$198.46
|
| Rate for Payer: Cigna of CA PPO |
$229.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$263.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$263.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$263.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.04
|
| Rate for Payer: EPIC Health Plan Senior |
$124.04
|
| Rate for Payer: Galaxy Health WC |
$263.58
|
| Rate for Payer: Global Benefits Group Commercial |
$186.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.09
|
| Rate for Payer: InnovAge PACE Commercial |
$155.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$217.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$217.07
|
| Rate for Payer: Multiplan Commercial |
$232.57
|
| Rate for Payer: Networks By Design Commercial |
$201.56
|
| Rate for Payer: Prime Health Services Commercial |
$263.58
|
| Rate for Payer: Riverside University Health System MISP |
$124.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$186.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$186.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.05
|
| Rate for Payer: United Healthcare All Other HMO |
$155.05
|
| Rate for Payer: United Healthcare HMO Rider |
$155.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$155.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$263.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$263.58
|
| Rate for Payer: Vantage Medical Group Senior |
$263.58
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
IP
|
$310.10
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.02 |
| Max. Negotiated Rate |
$279.09 |
| Rate for Payer: Adventist Health Commercial |
$62.02
|
| Rate for Payer: Cash Price |
$139.55
|
| Rate for Payer: Central Health Plan Commercial |
$248.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.04
|
| Rate for Payer: EPIC Health Plan Senior |
$124.04
|
| Rate for Payer: Galaxy Health WC |
$263.58
|
| Rate for Payer: Global Benefits Group Commercial |
$186.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$279.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.02
|
| Rate for Payer: Multiplan Commercial |
$232.57
|
| Rate for Payer: Networks By Design Commercial |
$201.56
|
| Rate for Payer: Prime Health Services Commercial |
$263.58
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$213.85
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
OP
|
$447.18
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.44 |
| Max. Negotiated Rate |
$402.46 |
| Rate for Payer: Adventist Health Commercial |
$89.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$271.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$380.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$245.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$216.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$262.63
|
| Rate for Payer: Blue Shield of California Commercial |
$273.23
|
| Rate for Payer: Blue Shield of California EPN |
$178.42
|
| Rate for Payer: Cash Price |
$201.23
|
| Rate for Payer: Central Health Plan Commercial |
$357.74
|
| Rate for Payer: Cigna of CA HMO |
$286.20
|
| Rate for Payer: Cigna of CA PPO |
$330.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$380.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$380.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$380.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.87
|
| Rate for Payer: EPIC Health Plan Senior |
$178.87
|
| Rate for Payer: Galaxy Health WC |
$380.10
|
| Rate for Payer: Global Benefits Group Commercial |
$268.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.46
|
| Rate for Payer: InnovAge PACE Commercial |
$223.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$298.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$313.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$313.03
|
| Rate for Payer: Multiplan Commercial |
$335.38
|
| Rate for Payer: Networks By Design Commercial |
$290.67
|
| Rate for Payer: Prime Health Services Commercial |
$380.10
|
| Rate for Payer: Riverside University Health System MISP |
$178.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$268.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$268.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$223.59
|
| Rate for Payer: United Healthcare All Other HMO |
$223.59
|
| Rate for Payer: United Healthcare HMO Rider |
$223.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$380.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$380.10
|
| Rate for Payer: Vantage Medical Group Senior |
$380.10
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
IP
|
$447.18
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.44 |
| Max. Negotiated Rate |
$402.46 |
| Rate for Payer: Adventist Health Commercial |
$89.44
|
| Rate for Payer: Cash Price |
$201.23
|
| Rate for Payer: Central Health Plan Commercial |
$357.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.87
|
| Rate for Payer: EPIC Health Plan Senior |
$178.87
|
| Rate for Payer: Galaxy Health WC |
$380.10
|
| Rate for Payer: Global Benefits Group Commercial |
$268.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$402.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$298.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.44
|
| Rate for Payer: Multiplan Commercial |
$335.38
|
| Rate for Payer: Networks By Design Commercial |
$290.67
|
| Rate for Payer: Prime Health Services Commercial |
$380.10
|
|
|
HC INTRO SHEATH 5FR
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901603290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.51
|
| Rate for Payer: Blue Shield of California Commercial |
$33.82
|
| Rate for Payer: Blue Shield of California EPN |
$22.08
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: InnovAge PACE Commercial |
$27.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.74
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 5FR
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901603290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 6FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 6FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.51
|
| Rate for Payer: Blue Shield of California Commercial |
$33.82
|
| Rate for Payer: Blue Shield of California EPN |
$22.08
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: InnovAge PACE Commercial |
$27.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.74
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 7FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.51
|
| Rate for Payer: Blue Shield of California Commercial |
$33.82
|
| Rate for Payer: Blue Shield of California EPN |
$22.08
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: InnovAge PACE Commercial |
$27.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.74
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 7FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 8FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 8FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$11.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.51
|
| Rate for Payer: Blue Shield of California Commercial |
$33.82
|
| Rate for Payer: Blue Shield of California EPN |
$22.08
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Senior |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.81
|
| Rate for Payer: InnovAge PACE Commercial |
$27.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.74
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SPINAL BD 406999
|
Facility
|
OP
|
$40.34
|
|
| Hospital Charge Code |
901604254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.69
|
| Rate for Payer: Blue Shield of California Commercial |
$24.65
|
| Rate for Payer: Blue Shield of California EPN |
$16.10
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$32.27
|
| Rate for Payer: Cigna of CA HMO |
$25.82
|
| Rate for Payer: Cigna of CA PPO |
$29.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.14
|
| Rate for Payer: EPIC Health Plan Senior |
$16.14
|
| Rate for Payer: Galaxy Health WC |
$34.29
|
| Rate for Payer: Global Benefits Group Commercial |
$24.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.31
|
| Rate for Payer: InnovAge PACE Commercial |
$20.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.24
|
| Rate for Payer: Multiplan Commercial |
$30.25
|
| Rate for Payer: Networks By Design Commercial |
$26.22
|
| Rate for Payer: Prime Health Services Commercial |
$34.29
|
| Rate for Payer: Riverside University Health System MISP |
$16.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.17
|
| Rate for Payer: United Healthcare All Other HMO |
$20.17
|
| Rate for Payer: United Healthcare HMO Rider |
$20.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.29
|
|
|
HC INTRO SPINAL BD 406999
|
Facility
|
IP
|
$40.34
|
|
| Hospital Charge Code |
901604254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.07
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$32.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.14
|
| Rate for Payer: EPIC Health Plan Senior |
$16.14
|
| Rate for Payer: Galaxy Health WC |
$34.29
|
| Rate for Payer: Global Benefits Group Commercial |
$24.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.07
|
| Rate for Payer: Multiplan Commercial |
$30.25
|
| Rate for Payer: Networks By Design Commercial |
$26.22
|
| Rate for Payer: Prime Health Services Commercial |
$34.29
|
|
|
HC INTRO TRACH PERCUT 7.5,8.5,9.0
|
Facility
|
IP
|
$1,766.95
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$353.39 |
| Max. Negotiated Rate |
$1,590.26 |
| Rate for Payer: Adventist Health Commercial |
$353.39
|
| Rate for Payer: Cash Price |
$795.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,413.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$706.78
|
| Rate for Payer: EPIC Health Plan Senior |
$706.78
|
| Rate for Payer: Galaxy Health WC |
$1,501.91
|
| Rate for Payer: Global Benefits Group Commercial |
$1,060.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,590.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,178.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$673.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,093.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.39
|
| Rate for Payer: Multiplan Commercial |
$1,325.21
|
| Rate for Payer: Networks By Design Commercial |
$1,148.52
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.91
|
|
|
HC INTRO TRACH PERCUT 7.5,8.5,9.0
|
Facility
|
OP
|
$1,766.95
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$353.39 |
| Max. Negotiated Rate |
$1,590.26 |
| Rate for Payer: Adventist Health Commercial |
$353.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,073.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,501.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$971.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,325.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$855.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,037.73
|
| Rate for Payer: Blue Shield of California Commercial |
$1,079.61
|
| Rate for Payer: Blue Shield of California EPN |
$705.01
|
| Rate for Payer: Cash Price |
$795.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,413.56
|
| Rate for Payer: Cigna of CA HMO |
$1,130.85
|
| Rate for Payer: Cigna of CA PPO |
$1,307.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,501.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,501.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,501.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$706.78
|
| Rate for Payer: EPIC Health Plan Senior |
$706.78
|
| Rate for Payer: Galaxy Health WC |
$1,501.91
|
| Rate for Payer: Global Benefits Group Commercial |
$1,060.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,590.26
|
| Rate for Payer: InnovAge PACE Commercial |
$883.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,178.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$673.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,093.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,236.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,236.87
|
| Rate for Payer: Multiplan Commercial |
$1,325.21
|
| Rate for Payer: Networks By Design Commercial |
$1,148.52
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.91
|
| Rate for Payer: Riverside University Health System MISP |
$706.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,060.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,060.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$883.48
|
| Rate for Payer: United Healthcare All Other HMO |
$883.48
|
| Rate for Payer: United Healthcare HMO Rider |
$883.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$883.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,501.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,501.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,501.91
|
|
|
HC INTRO TRACH PERCUTANEOUS 7.5MM
|
Facility
|
OP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Adventist Health Commercial |
$435.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,321.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,197.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,632.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,053.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,278.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1,330.01
|
| Rate for Payer: Blue Shield of California EPN |
$868.53
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: Cigna of CA HMO |
$1,393.13
|
| Rate for Payer: Cigna of CA PPO |
$1,610.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,850.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,850.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Senior |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: InnovAge PACE Commercial |
$1,088.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,523.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,523.74
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
| Rate for Payer: Riverside University Health System MISP |
$870.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,306.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,306.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,088.38
|
| Rate for Payer: United Healthcare All Other HMO |
$1,088.38
|
| Rate for Payer: United Healthcare HMO Rider |
$1,088.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,088.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 7.5MM
|
Facility
|
IP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Adventist Health Commercial |
$435.35
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Senior |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 8.5MM
|
Facility
|
OP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Adventist Health Commercial |
$435.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,321.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,197.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,632.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,053.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,278.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1,330.01
|
| Rate for Payer: Blue Shield of California EPN |
$868.53
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: Cigna of CA HMO |
$1,393.13
|
| Rate for Payer: Cigna of CA PPO |
$1,610.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,850.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,850.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Senior |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: InnovAge PACE Commercial |
$1,088.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,523.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,523.74
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
| Rate for Payer: Riverside University Health System MISP |
$870.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,306.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,306.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,088.38
|
| Rate for Payer: United Healthcare All Other HMO |
$1,088.38
|
| Rate for Payer: United Healthcare HMO Rider |
$1,088.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,088.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 8.5MM
|
Facility
|
IP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Adventist Health Commercial |
$435.35
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Senior |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
|
|
HC INTRO TRACH PERQ COOK 15GA
|
Facility
|
IP
|
$2,194.48
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901604420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$438.90 |
| Max. Negotiated Rate |
$1,975.03 |
| Rate for Payer: Adventist Health Commercial |
$438.90
|
| Rate for Payer: Cash Price |
$987.52
|
| Rate for Payer: Central Health Plan Commercial |
$1,755.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$877.79
|
| Rate for Payer: EPIC Health Plan Senior |
$877.79
|
| Rate for Payer: Galaxy Health WC |
$1,865.31
|
| Rate for Payer: Global Benefits Group Commercial |
$1,316.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,975.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,463.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$836.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,358.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.90
|
| Rate for Payer: Multiplan Commercial |
$1,645.86
|
| Rate for Payer: Networks By Design Commercial |
$1,426.41
|
| Rate for Payer: Prime Health Services Commercial |
$1,865.31
|
|
|
HC INTRO TRACH PERQ COOK 15GA
|
Facility
|
OP
|
$2,194.48
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901604420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$438.90 |
| Max. Negotiated Rate |
$1,975.03 |
| Rate for Payer: Adventist Health Commercial |
$438.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,332.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,865.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,206.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,645.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,062.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,288.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,340.83
|
| Rate for Payer: Blue Shield of California EPN |
$875.60
|
| Rate for Payer: Cash Price |
$987.52
|
| Rate for Payer: Central Health Plan Commercial |
$1,755.58
|
| Rate for Payer: Cigna of CA HMO |
$1,404.47
|
| Rate for Payer: Cigna of CA PPO |
$1,623.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,865.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,865.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,865.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$877.79
|
| Rate for Payer: EPIC Health Plan Senior |
$877.79
|
| Rate for Payer: Galaxy Health WC |
$1,865.31
|
| Rate for Payer: Global Benefits Group Commercial |
$1,316.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,975.03
|
| Rate for Payer: InnovAge PACE Commercial |
$1,097.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,463.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$836.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,358.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,536.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,536.14
|
| Rate for Payer: Multiplan Commercial |
$1,645.86
|
| Rate for Payer: Networks By Design Commercial |
$1,426.41
|
| Rate for Payer: Prime Health Services Commercial |
$1,865.31
|
| Rate for Payer: Riverside University Health System MISP |
$877.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,316.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,316.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,097.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,097.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,097.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,865.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,865.31
|
| Rate for Payer: Vantage Medical Group Senior |
$1,865.31
|
|
|
HC INT SKIN BARRIER ROLL 10"X144"
|
Facility
|
IP
|
$340.34
|
|
| Hospital Charge Code |
901698564
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: Central Health Plan Commercial |
$272.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$306.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$210.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.07
|
| Rate for Payer: Multiplan Commercial |
$255.25
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
|
