|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$573.69 |
| Max. Negotiated Rate |
$29,007.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,989.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,727.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,727.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$19,338.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Central Health Plan Commercial |
$25,784.80
|
| Rate for Payer: Cigna of CA PPO |
$23,850.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Dignity Health Media |
$27,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,396.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,007.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,173.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,280.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,446.20
|
| Rate for Payer: Multiplan Commercial |
$24,173.25
|
| Rate for Payer: Networks By Design Commercial |
$20,950.15
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
| Rate for Payer: Riverside University Health System MISP |
$12,892.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,338.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,396.35
|
| Rate for Payer: Vantage Medical Group Senior |
$27,396.35
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
OP
|
$11,981.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$370.37 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,188.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,584.80
|
| Rate for Payer: Cigna of CA PPO |
$8,865.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$10,183.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,782.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,985.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,132.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: InnovAge PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,991.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,396.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$8,985.75
|
| Rate for Payer: Networks By Design Commercial |
$7,787.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,183.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
IP
|
$11,981.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,396.20 |
| Max. Negotiated Rate |
$10,782.90 |
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,584.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.40
|
| Rate for Payer: Galaxy Health WC |
$10,183.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,188.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,782.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,991.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,564.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,396.20
|
| Rate for Payer: Multiplan Commercial |
$8,985.75
|
| Rate for Payer: Networks By Design Commercial |
$7,787.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,183.85
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
IP
|
$13,818.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,763.60 |
| Max. Negotiated Rate |
$12,436.20 |
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: Central Health Plan Commercial |
$11,054.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,527.20
|
| Rate for Payer: Galaxy Health WC |
$11,745.30
|
| Rate for Payer: Global Benefits Group Commercial |
$8,290.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,436.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,264.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,763.60
|
| Rate for Payer: Multiplan Commercial |
$10,363.50
|
| Rate for Payer: Networks By Design Commercial |
$8,981.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,745.30
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
OP
|
$13,818.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,138.86 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,290.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: Central Health Plan Commercial |
$11,054.40
|
| Rate for Payer: Cigna of CA PPO |
$10,225.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$11,745.30
|
| Rate for Payer: Global Benefits Group Commercial |
$8,290.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,436.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,363.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,132.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: InnovAge PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,763.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$10,363.50
|
| Rate for Payer: Networks By Design Commercial |
$8,981.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,745.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,290.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
IP
|
$9,424.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,884.80 |
| Max. Negotiated Rate |
$8,481.60 |
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,539.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,769.60
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,481.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,590.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,884.80
|
| Rate for Payer: Multiplan Commercial |
$7,068.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
OP
|
$9,424.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.06 |
| Max. Negotiated Rate |
$8,481.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,654.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,539.20
|
| Rate for Payer: Cigna of CA PPO |
$6,973.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,481.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,068.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,884.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$7,068.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,654.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,712.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,712.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,712.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,349.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906820004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,931.60 |
| Max. Negotiated Rate |
$71,692.20 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,349.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906820004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$966.97 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$41,105.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,196.73
|
| Rate for Payer: Blue Distinction Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$41,105.24
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67,823.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: InnovAge PACE Commercial |
$61,657.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$966.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,081.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Preferred Health Network WC |
$57,343.60
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$43,571.55
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Riverside University Health System MISP |
$45,215.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$966.97 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$41,105.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,548.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,196.73
|
| Rate for Payer: Blue Distinction Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$41,105.24
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Central Health Plan Commercial |
$63,726.40
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$71,692.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67,823.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: InnovAge PACE Commercial |
$61,657.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$966.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,931.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,081.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$59,743.50
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Preferred Health Network WC |
$57,343.60
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services Medicare |
$43,571.55
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Riverside University Health System MISP |
$45,215.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
OP
|
$7,013.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.45 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,207.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$3,155.85
|
| Rate for Payer: Cash Price |
$3,155.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,610.40
|
| Rate for Payer: Cigna of CA PPO |
$5,189.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$5,961.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,207.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,311.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,259.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,199.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$523.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,402.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$5,259.75
|
| Rate for Payer: Networks By Design Commercial |
$4,558.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,961.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Riverside University Health System MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,207.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
IP
|
$7,013.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,402.60 |
| Max. Negotiated Rate |
$6,311.70 |
| Rate for Payer: Cash Price |
$3,155.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,610.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,805.20
|
| Rate for Payer: Galaxy Health WC |
$5,961.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,207.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,311.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,671.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,402.60
|
| Rate for Payer: Multiplan Commercial |
$5,259.75
|
| Rate for Payer: Networks By Design Commercial |
$4,558.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,961.05
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$495.20 |
| Max. Negotiated Rate |
$2,228.40 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$990.40
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,579.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,485.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: Cigna of CA PPO |
$1,832.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: InnovAge PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,485.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,485.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$495.20 |
| Max. Negotiated Rate |
$2,228.40 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$990.40
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,579.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,485.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: Cigna of CA PPO |
$1,832.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: InnovAge PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,238.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,238.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,238.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,238.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$495.20 |
| Max. Negotiated Rate |
$2,228.40 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$990.40
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,579.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,485.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,980.80
|
| Rate for Payer: Cigna of CA PPO |
$1,832.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,228.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: InnovAge PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$495.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$1,857.00
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,485.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,485.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$927.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$556.20
|
| Rate for Payer: Blue Shield of California Commercial |
$583.08
|
| Rate for Payer: Blue Shield of California EPN |
$453.30
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$417.15
|
| Rate for Payer: Cash Price |
$417.15
|
| Rate for Payer: Central Health Plan Commercial |
$741.60
|
| Rate for Payer: Cigna of CA HMO |
$593.28
|
| Rate for Payer: Cigna of CA PPO |
$685.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$787.95
|
| Rate for Payer: Global Benefits Group Commercial |
$556.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$834.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$695.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$618.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$695.25
|
| Rate for Payer: Networks By Design Commercial |
$602.55
|
| Rate for Payer: Prime Health Services Commercial |
$787.95
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$556.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$556.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$463.50
|
| Rate for Payer: United Healthcare All Other HMO |
$463.50
|
| Rate for Payer: United Healthcare HMO Rider |
$463.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$463.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$578.40
|
| Rate for Payer: Blue Shield of California Commercial |
$606.36
|
| Rate for Payer: Blue Shield of California EPN |
$471.40
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| Rate for Payer: Cigna of CA HMO |
$616.96
|
| Rate for Payer: Cigna of CA PPO |
$713.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$819.40
|
| Rate for Payer: Global Benefits Group Commercial |
$578.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$867.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$723.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: Networks By Design Commercial |
$626.60
|
| Rate for Payer: Prime Health Services Commercial |
$819.40
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$578.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$578.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$482.00
|
| Rate for Payer: United Healthcare All Other HMO |
$482.00
|
| Rate for Payer: United Healthcare HMO Rider |
$482.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$578.40
|
| Rate for Payer: Blue Shield of California Commercial |
$606.36
|
| Rate for Payer: Blue Shield of California EPN |
$471.40
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| Rate for Payer: Cigna of CA HMO |
$616.96
|
| Rate for Payer: Cigna of CA PPO |
$713.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$819.40
|
| Rate for Payer: Global Benefits Group Commercial |
$578.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$867.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$723.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: Networks By Design Commercial |
$626.60
|
| Rate for Payer: Prime Health Services Commercial |
$819.40
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$578.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$578.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$482.00
|
| Rate for Payer: United Healthcare All Other HMO |
$482.00
|
| Rate for Payer: United Healthcare HMO Rider |
$482.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906820336
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$192.80 |
| Max. Negotiated Rate |
$867.60 |
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.60
|
| Rate for Payer: Galaxy Health WC |
$819.40
|
| Rate for Payer: Global Benefits Group Commercial |
$578.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$867.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.80
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: Networks By Design Commercial |
$626.60
|
| Rate for Payer: Prime Health Services Commercial |
$819.40
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$192.80 |
| Max. Negotiated Rate |
$867.60 |
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.60
|
| Rate for Payer: Galaxy Health WC |
$819.40
|
| Rate for Payer: Global Benefits Group Commercial |
$578.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$867.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.80
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: Networks By Design Commercial |
$626.60
|
| Rate for Payer: Prime Health Services Commercial |
$819.40
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$192.80 |
| Max. Negotiated Rate |
$867.60 |
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.60
|
| Rate for Payer: Galaxy Health WC |
$819.40
|
| Rate for Payer: Global Benefits Group Commercial |
$578.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$867.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.80
|
| Rate for Payer: Multiplan Commercial |
$723.00
|
| Rate for Payer: Networks By Design Commercial |
$626.60
|
| Rate for Payer: Prime Health Services Commercial |
$819.40
|
|
