|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
720
|
| 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: 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 |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| 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
|
361
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$7,609.02 |
| 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 |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| 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: Cash Price |
$433.80
|
| Rate for Payer: Central Health Plan Commercial |
$771.20
|
| 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: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| 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
|
450
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$578.40
|
| 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: 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 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 |
$936.00
|
| 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: 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
|
$927.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906551702
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.40 |
| Max. Negotiated Rate |
$834.30 |
| Rate for Payer: Cash Price |
$417.15
|
| Rate for Payer: Central Health Plan Commercial |
$741.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$618.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$353.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.40
|
| 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
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
361
|
| 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
|
OP
|
$964.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
510
|
| 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
|
516
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,901.00 |
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| 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: 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 |
906811256
|
|
Hospital Revenue Code
|
516
|
| 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
|
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
|
450
|
| 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 INTRAPERITONEAL CATH
|
Facility
|
IP
|
$11,064.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,212.80 |
| Max. Negotiated Rate |
$9,957.60 |
| Rate for Payer: Cash Price |
$4,978.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,851.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,425.60
|
| Rate for Payer: Galaxy Health WC |
$9,404.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,638.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,957.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,379.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,215.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,212.80
|
| Rate for Payer: Multiplan Commercial |
$8,298.00
|
| Rate for Payer: Networks By Design Commercial |
$7,191.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,404.40
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$11,064.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$497.29 |
| 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 |
$6,638.40
|
| 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 |
$4,978.80
|
| Rate for Payer: Cash Price |
$4,978.80
|
| Rate for Payer: Central Health Plan Commercial |
$8,851.20
|
| Rate for Payer: Cigna of CA PPO |
$8,187.36
|
| 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 |
$9,404.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,638.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,957.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,298.00
|
| 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 |
$7,379.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$497.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,212.80
|
| 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 |
$8,298.00
|
| Rate for Payer: Networks By Design Commercial |
$7,191.60
|
| Rate for Payer: Prime Health Services Commercial |
$9,404.40
|
| 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 |
$6,638.40
|
| 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 URINARY CATH COMPLICATED
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$542.40
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: Cigna of CA PPO |
$668.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$678.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$542.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.00
|
| Rate for Payer: United Healthcare All Other HMO |
$452.00
|
| Rate for Payer: United Healthcare HMO Rider |
$452.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$452.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| 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 |
$542.40
|
| Rate for Payer: Blue Shield of California Commercial |
$568.62
|
| Rate for Payer: Blue Shield of California EPN |
$442.06
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: Cigna of CA HMO |
$578.56
|
| Rate for Payer: Cigna of CA PPO |
$668.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$678.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$542.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$542.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$813.60 |
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.60
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$813.60 |
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.60
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$542.40
|
| Rate for Payer: Blue Shield of California Commercial |
$568.62
|
| Rate for Payer: Blue Shield of California EPN |
$442.06
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: Cigna of CA HMO |
$578.56
|
| Rate for Payer: Cigna of CA PPO |
$668.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$678.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$542.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$542.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.00
|
| Rate for Payer: United Healthcare All Other HMO |
$452.00
|
| Rate for Payer: United Healthcare HMO Rider |
$452.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$452.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$813.60 |
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.60
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| 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 |
$542.40
|
| Rate for Payer: Blue Shield of California Commercial |
$568.62
|
| Rate for Payer: Blue Shield of California EPN |
$442.06
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: Cigna of CA HMO |
$578.56
|
| Rate for Payer: Cigna of CA PPO |
$668.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$678.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$542.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$542.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.00
|
| Rate for Payer: United Healthcare All Other HMO |
$452.00
|
| Rate for Payer: United Healthcare HMO Rider |
$452.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$452.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$813.60 |
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Central Health Plan Commercial |
$723.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.60
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$813.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.80
|
| Rate for Payer: Multiplan Commercial |
$678.00
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$667.05 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,253.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,265.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,265.95
|
| 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 |
$9,017.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,023.20
|
| Rate for Payer: Cigna of CA PPO |
$11,121.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Dignity Health Media |
$12,774.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,774.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,526.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,271.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,260.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$667.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,005.80
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
| Rate for Payer: Networks By Design Commercial |
$9,768.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
| Rate for Payer: Riverside University Health System MISP |
$6,011.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,017.40
|
| 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 |
$12,774.65
|
| Rate for Payer: Vantage Medical Group Senior |
$12,774.65
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906820232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,005.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,023.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,526.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,726.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,005.80
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$667.05 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,253.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,265.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,265.95
|
| 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 |
$9,017.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,023.20
|
| Rate for Payer: Cigna of CA PPO |
$11,121.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Dignity Health Media |
$12,774.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,774.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,526.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,271.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,260.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$667.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,005.80
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
| Rate for Payer: Networks By Design Commercial |
$9,768.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
| Rate for Payer: Riverside University Health System MISP |
$6,011.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,017.40
|
| 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 |
$12,774.65
|
| Rate for Payer: Vantage Medical Group Senior |
$12,774.65
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,005.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,023.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,526.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,726.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,005.80
|
| Rate for Payer: Multiplan Commercial |
$11,271.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
|
|
HC INSOLE FELT SHOE ADD
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT L3520
|
| Hospital Charge Code |
905353520
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Blue Shield of California EPN |
$33.11
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Central Health Plan Commercial |
$49.60
|
| Rate for Payer: Cigna of CA HMO |
$43.40
|
| Rate for Payer: Cigna of CA PPO |
$43.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.80
|
| Rate for Payer: Galaxy Health WC |
$52.70
|
| Rate for Payer: Global Benefits Group Commercial |
$37.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.40
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: Networks By Design Commercial |
$31.00
|
| Rate for Payer: Prime Health Services Commercial |
$52.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.41
|
| Rate for Payer: United Healthcare All Other HMO |
$22.87
|
| Rate for Payer: United Healthcare HMO Rider |
$22.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
|
