|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC INTRO PICC SHEATH 1.4FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: Blue Distinction Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Media |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
IP
|
$256.06
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.21 |
| Max. Negotiated Rate |
$230.45 |
| Rate for Payer: Cash Price |
$115.23
|
| Rate for Payer: Central Health Plan Commercial |
$204.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.42
|
| Rate for Payer: Galaxy Health WC |
$217.65
|
| Rate for Payer: Global Benefits Group Commercial |
$153.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.21
|
| Rate for Payer: Multiplan Commercial |
$192.04
|
| Rate for Payer: Networks By Design Commercial |
$166.44
|
| Rate for Payer: Prime Health Services Commercial |
$217.65
|
|
|
HC INTRO SHEATH 1.9 NEOPICC
|
Facility
|
OP
|
$256.06
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.21 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$217.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.28
|
| Rate for Payer: Blue Distinction Transplant |
$153.64
|
| Rate for Payer: Blue Shield of California Commercial |
$161.06
|
| Rate for Payer: Blue Shield of California EPN |
$125.21
|
| Rate for Payer: Cash Price |
$115.23
|
| Rate for Payer: Cash Price |
$115.23
|
| Rate for Payer: Central Health Plan Commercial |
$204.85
|
| Rate for Payer: Cigna of CA HMO |
$163.88
|
| Rate for Payer: Cigna of CA PPO |
$189.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.65
|
| Rate for Payer: Dignity Health Media |
$217.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$217.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$102.42
|
| Rate for Payer: Galaxy Health WC |
$217.65
|
| Rate for Payer: Global Benefits Group Commercial |
$153.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$230.45
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$192.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$170.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.21
|
| Rate for Payer: Multiplan Commercial |
$192.04
|
| Rate for Payer: Networks By Design Commercial |
$166.44
|
| Rate for Payer: Prime Health Services Commercial |
$217.65
|
| Rate for Payer: Riverside University Health System MISP |
$102.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$153.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$153.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$128.03
|
| Rate for Payer: United Healthcare All Other HMO |
$128.03
|
| Rate for Payer: United Healthcare HMO Rider |
$128.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$217.65
|
| Rate for Payer: Vantage Medical Group Senior |
$217.65
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: Blue Distinction Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Media |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC INTRO SHEATH 3.0FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602803
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
OP
|
$429.95
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.99 |
| Max. Negotiated Rate |
$386.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$365.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$236.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$236.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$208.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$254.01
|
| Rate for Payer: Blue Distinction Transplant |
$257.97
|
| Rate for Payer: Blue Shield of California Commercial |
$270.44
|
| Rate for Payer: Blue Shield of California EPN |
$210.25
|
| Rate for Payer: Cash Price |
$193.48
|
| Rate for Payer: Cash Price |
$193.48
|
| Rate for Payer: Central Health Plan Commercial |
$343.96
|
| Rate for Payer: Cigna of CA HMO |
$275.17
|
| Rate for Payer: Cigna of CA PPO |
$318.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$365.46
|
| Rate for Payer: Dignity Health Media |
$365.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$365.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$171.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$171.98
|
| Rate for Payer: Galaxy Health WC |
$365.46
|
| Rate for Payer: Global Benefits Group Commercial |
$257.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$386.96
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$322.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$150.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$286.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.99
|
| Rate for Payer: Multiplan Commercial |
$322.46
|
| Rate for Payer: Networks By Design Commercial |
$279.47
|
| Rate for Payer: Prime Health Services Commercial |
$365.46
|
| Rate for Payer: Riverside University Health System MISP |
$171.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$257.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$257.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$214.98
|
| Rate for Payer: United Healthcare All Other HMO |
$214.98
|
| Rate for Payer: United Healthcare HMO Rider |
$214.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$365.46
|
| Rate for Payer: Vantage Medical Group Senior |
$365.46
|
|
|
HC INTRO SHEATH 4.0FR
|
Facility
|
IP
|
$429.95
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.99 |
| Max. Negotiated Rate |
$386.96 |
| Rate for Payer: Cash Price |
$193.48
|
| Rate for Payer: Central Health Plan Commercial |
$343.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$171.98
|
| Rate for Payer: Galaxy Health WC |
$365.46
|
| Rate for Payer: Global Benefits Group Commercial |
$257.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$386.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$286.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.99
|
| Rate for Payer: Multiplan Commercial |
$322.46
|
| Rate for Payer: Networks By Design Commercial |
$279.47
|
| Rate for Payer: Prime Health Services Commercial |
$365.46
|
|
|
HC INTRO SHEATH 5FR
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901603290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 5FR
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901603290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.70
|
| Rate for Payer: Blue Distinction Transplant |
$33.21
|
| Rate for Payer: Blue Shield of California Commercial |
$34.82
|
| Rate for Payer: Blue Shield of California EPN |
$27.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Media |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 6FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.70
|
| Rate for Payer: Blue Distinction Transplant |
$33.21
|
| Rate for Payer: Blue Shield of California Commercial |
$34.82
|
| Rate for Payer: Blue Shield of California EPN |
$27.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Media |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 6FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 7FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.70
|
| Rate for Payer: Blue Distinction Transplant |
$33.21
|
| Rate for Payer: Blue Shield of California Commercial |
$34.82
|
| Rate for Payer: Blue Shield of California EPN |
$27.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Media |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 7FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SHEATH 8FR ADULT
|
Facility
|
OP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.70
|
| Rate for Payer: Blue Distinction Transplant |
$33.21
|
| Rate for Payer: Blue Shield of California Commercial |
$34.82
|
| Rate for Payer: Blue Shield of California EPN |
$27.07
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: Cigna of CA HMO |
$35.42
|
| Rate for Payer: Cigna of CA PPO |
$40.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.05
|
| Rate for Payer: Dignity Health Media |
$47.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.68
|
| Rate for Payer: United Healthcare All Other HMO |
$27.68
|
| Rate for Payer: United Healthcare HMO Rider |
$27.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.05
|
| Rate for Payer: Vantage Medical Group Senior |
$47.05
|
|
|
HC INTRO SHEATH 8FR ADULT
|
Facility
|
IP
|
$55.35
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901602174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Cash Price |
$24.91
|
| Rate for Payer: Central Health Plan Commercial |
$44.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.14
|
| Rate for Payer: Galaxy Health WC |
$47.05
|
| Rate for Payer: Global Benefits Group Commercial |
$33.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.07
|
| Rate for Payer: Multiplan Commercial |
$41.51
|
| Rate for Payer: Networks By Design Commercial |
$35.98
|
| Rate for Payer: Prime Health Services Commercial |
$47.05
|
|
|
HC INTRO SPINAL BD 406999
|
Facility
|
OP
|
$40.34
|
|
| Hospital Charge Code |
901604254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.83
|
| Rate for Payer: Blue Distinction Transplant |
$24.20
|
| Rate for Payer: Blue Shield of California Commercial |
$25.37
|
| Rate for Payer: Blue Shield of California EPN |
$19.73
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$32.27
|
| Rate for Payer: Cigna of CA HMO |
$25.82
|
| Rate for Payer: Cigna of CA PPO |
$29.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.29
|
| Rate for Payer: Dignity Health Media |
$34.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.14
|
| Rate for Payer: Galaxy Health WC |
$34.29
|
| Rate for Payer: Global Benefits Group Commercial |
$24.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.31
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.07
|
| Rate for Payer: Multiplan Commercial |
$30.26
|
| Rate for Payer: Networks By Design Commercial |
$26.22
|
| Rate for Payer: Prime Health Services Commercial |
$34.29
|
| Rate for Payer: Riverside University Health System MISP |
$16.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.17
|
| Rate for Payer: United Healthcare All Other HMO |
$20.17
|
| Rate for Payer: United Healthcare HMO Rider |
$20.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.29
|
|
|
HC INTRO SPINAL BD 406999
|
Facility
|
IP
|
$40.34
|
|
| Hospital Charge Code |
901604254
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$32.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.14
|
| Rate for Payer: Galaxy Health WC |
$34.29
|
| Rate for Payer: Global Benefits Group Commercial |
$24.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.07
|
| Rate for Payer: Multiplan Commercial |
$30.26
|
| Rate for Payer: Networks By Design Commercial |
$26.22
|
| Rate for Payer: Prime Health Services Commercial |
$34.29
|
|
|
HC INTRO TRACH PERCUT 7.5,8.5,9.0
|
Facility
|
OP
|
$1,766.95
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$353.39 |
| Max. Negotiated Rate |
$1,590.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,501.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$971.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$971.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$855.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,043.91
|
| Rate for Payer: Blue Distinction Transplant |
$1,060.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1,111.41
|
| Rate for Payer: Blue Shield of California EPN |
$864.04
|
| Rate for Payer: Cash Price |
$795.13
|
| Rate for Payer: Cash Price |
$795.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,413.56
|
| Rate for Payer: Cigna of CA HMO |
$1,130.85
|
| Rate for Payer: Cigna of CA PPO |
$1,307.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,501.91
|
| Rate for Payer: Dignity Health Media |
$1,501.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,501.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$706.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$706.78
|
| Rate for Payer: Galaxy Health WC |
$1,501.91
|
| Rate for Payer: Global Benefits Group Commercial |
$1,060.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,590.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,325.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$618.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,178.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$673.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.39
|
| Rate for Payer: Multiplan Commercial |
$1,325.21
|
| Rate for Payer: Networks By Design Commercial |
$1,148.52
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.91
|
| Rate for Payer: Riverside University Health System MISP |
$706.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,060.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,060.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$883.48
|
| Rate for Payer: United Healthcare All Other HMO |
$883.48
|
| Rate for Payer: United Healthcare HMO Rider |
$883.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$883.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,501.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,501.91
|
|
|
HC INTRO TRACH PERCUT 7.5,8.5,9.0
|
Facility
|
IP
|
$1,766.95
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698547
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$353.39 |
| Max. Negotiated Rate |
$1,590.26 |
| Rate for Payer: Cash Price |
$795.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,413.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$706.78
|
| Rate for Payer: Galaxy Health WC |
$1,501.91
|
| Rate for Payer: Global Benefits Group Commercial |
$1,060.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,590.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,178.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$673.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.39
|
| Rate for Payer: Multiplan Commercial |
$1,325.21
|
| Rate for Payer: Networks By Design Commercial |
$1,148.52
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.91
|
|
|
HC INTRO TRACH PERCUTANEOUS 7.5MM
|
Facility
|
IP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 7.5MM
|
Facility
|
OP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,197.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,197.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,053.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,286.04
|
| Rate for Payer: Blue Distinction Transplant |
$1,306.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,369.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,064.44
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: Cigna of CA HMO |
$1,393.13
|
| Rate for Payer: Cigna of CA PPO |
$1,610.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Dignity Health Media |
$1,850.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,850.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,632.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$761.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
| Rate for Payer: Riverside University Health System MISP |
$870.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,306.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,306.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,088.38
|
| Rate for Payer: United Healthcare All Other HMO |
$1,088.38
|
| Rate for Payer: United Healthcare HMO Rider |
$1,088.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,088.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 8.5MM
|
Facility
|
OP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,197.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,197.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,053.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,286.04
|
| Rate for Payer: Blue Distinction Transplant |
$1,306.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,369.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,064.44
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: Cigna of CA HMO |
$1,393.13
|
| Rate for Payer: Cigna of CA PPO |
$1,610.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,850.25
|
| Rate for Payer: Dignity Health Media |
$1,850.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,850.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,632.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$761.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
| Rate for Payer: Riverside University Health System MISP |
$870.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,306.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,306.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,088.38
|
| Rate for Payer: United Healthcare All Other HMO |
$1,088.38
|
| Rate for Payer: United Healthcare HMO Rider |
$1,088.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,088.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,850.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,850.25
|
|
|
HC INTRO TRACH PERCUTANEOUS 8.5MM
|
Facility
|
IP
|
$2,176.77
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698514
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$435.35 |
| Max. Negotiated Rate |
$1,959.09 |
| Rate for Payer: Cash Price |
$979.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,741.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$870.71
|
| Rate for Payer: Galaxy Health WC |
$1,850.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,306.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,959.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,451.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$829.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$435.35
|
| Rate for Payer: Multiplan Commercial |
$1,632.58
|
| Rate for Payer: Networks By Design Commercial |
$1,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,850.25
|
|
|
HC INTRO TRACH PERQ COOK 15GA
|
Facility
|
IP
|
$2,194.48
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901604420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$438.90 |
| Max. Negotiated Rate |
$1,975.03 |
| Rate for Payer: Cash Price |
$987.52
|
| Rate for Payer: Central Health Plan Commercial |
$1,755.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$877.79
|
| Rate for Payer: Galaxy Health WC |
$1,865.31
|
| Rate for Payer: Global Benefits Group Commercial |
$1,316.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,975.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,463.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$836.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.90
|
| Rate for Payer: Multiplan Commercial |
$1,645.86
|
| Rate for Payer: Networks By Design Commercial |
$1,426.41
|
| Rate for Payer: Prime Health Services Commercial |
$1,865.31
|
|
