|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Adventist Health Commercial |
$150.00
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Central Health Plan Commercial |
$600.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$525.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$300.00
|
| Rate for Payer: Galaxy Health WC |
$637.50
|
| Rate for Payer: Global Benefits Group Commercial |
$450.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$675.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$476.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$442.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Multiplan Commercial |
$562.50
|
| Rate for Payer: Networks By Design Commercial |
$487.50
|
| Rate for Payer: Prime Health Services Commercial |
$637.50
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$307.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$238.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Central Health Plan Commercial |
$600.00
|
| Rate for Payer: Cigna of CA HMO |
$480.00
|
| Rate for Payer: Cigna of CA PPO |
$555.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$525.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$637.50
|
| Rate for Payer: Global Benefits Group Commercial |
$450.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$675.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$476.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$562.50
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$487.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$637.50
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$450.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$450.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Adventist Health Commercial |
$150.00
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Central Health Plan Commercial |
$600.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$525.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$300.00
|
| Rate for Payer: EPIC Health Plan Senior |
$300.00
|
| Rate for Payer: Galaxy Health WC |
$637.50
|
| Rate for Payer: Global Benefits Group Commercial |
$450.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$675.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$476.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$442.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Multiplan Commercial |
$562.50
|
| Rate for Payer: Networks By Design Commercial |
$487.50
|
| Rate for Payer: Prime Health Services Commercial |
$637.50
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$150.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Cash Price |
$337.50
|
| Rate for Payer: Central Health Plan Commercial |
$600.00
|
| Rate for Payer: Cigna of CA HMO |
$480.00
|
| Rate for Payer: Cigna of CA PPO |
$555.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$525.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$637.50
|
| Rate for Payer: Global Benefits Group Commercial |
$450.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$675.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$476.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$562.50
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$487.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$637.50
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$450.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$375.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$375.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC SHEATH GLIDETHRU 4.5FR 7CM
|
Facility
|
OP
|
$121.60
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$24.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$103.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$91.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.73
|
| Rate for Payer: Blue Shield of California Commercial |
$77.09
|
| Rate for Payer: Blue Shield of California EPN |
$48.52
|
| Rate for Payer: Cash Price |
$54.72
|
| Rate for Payer: Cash Price |
$54.72
|
| Rate for Payer: Central Health Plan Commercial |
$97.28
|
| Rate for Payer: Cigna of CA HMO |
$77.82
|
| Rate for Payer: Cigna of CA PPO |
$89.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$103.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$103.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$103.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.64
|
| Rate for Payer: EPIC Health Plan Senior |
$48.64
|
| Rate for Payer: Galaxy Health WC |
$103.36
|
| Rate for Payer: Global Benefits Group Commercial |
$72.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$85.12
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Networks By Design Commercial |
$79.04
|
| Rate for Payer: Prime Health Services Commercial |
$103.36
|
| Rate for Payer: Riverside University Health System MISP |
$48.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.80
|
| Rate for Payer: United Healthcare All Other HMO |
$60.80
|
| Rate for Payer: United Healthcare HMO Rider |
$60.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$103.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$103.36
|
| Rate for Payer: Vantage Medical Group Senior |
$103.36
|
|
|
HC SHEATH GLIDETHRU 4.5FR 7CM
|
Facility
|
IP
|
$121.60
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$109.44 |
| Rate for Payer: Adventist Health Commercial |
$24.32
|
| Rate for Payer: Cash Price |
$54.72
|
| Rate for Payer: Central Health Plan Commercial |
$97.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.64
|
| Rate for Payer: EPIC Health Plan Senior |
$48.64
|
| Rate for Payer: Galaxy Health WC |
$103.36
|
| Rate for Payer: Global Benefits Group Commercial |
$72.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.32
|
| Rate for Payer: Multiplan Commercial |
$91.20
|
| Rate for Payer: Networks By Design Commercial |
$79.04
|
| Rate for Payer: Prime Health Services Commercial |
$103.36
|
|
|
HC SHEATH GLIDETHRU 4FR 7CM
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.58
|
| Rate for Payer: Blue Shield of California Commercial |
$97.64
|
| Rate for Payer: Blue Shield of California EPN |
$61.45
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$130.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Senior |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$107.80
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Riverside University Health System MISP |
$61.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$77.00
|
| Rate for Payer: United Healthcare All Other HMO |
$77.00
|
| Rate for Payer: United Healthcare HMO Rider |
$77.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Vantage Medical Group Senior |
$130.90
|
|
|
HC SHEATH GLIDETHRU 4FR 7CM
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Senior |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
|
|
HC SHEATH GLIDETHRU 5.5FR 7CM
|
Facility
|
IP
|
$120.84
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607735
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$108.76 |
| Rate for Payer: Adventist Health Commercial |
$24.17
|
| Rate for Payer: Cash Price |
$54.38
|
| Rate for Payer: Central Health Plan Commercial |
$96.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.34
|
| Rate for Payer: EPIC Health Plan Senior |
$48.34
|
| Rate for Payer: Galaxy Health WC |
$102.71
|
| Rate for Payer: Global Benefits Group Commercial |
$72.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.17
|
| Rate for Payer: Multiplan Commercial |
$90.63
|
| Rate for Payer: Networks By Design Commercial |
$78.55
|
| Rate for Payer: Prime Health Services Commercial |
$102.71
|
|
|
HC SHEATH GLIDETHRU 5.5FR 7CM
|
Facility
|
OP
|
$120.84
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607735
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$24.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.29
|
| Rate for Payer: Blue Shield of California Commercial |
$76.61
|
| Rate for Payer: Blue Shield of California EPN |
$48.22
|
| Rate for Payer: Cash Price |
$54.38
|
| Rate for Payer: Cash Price |
$54.38
|
| Rate for Payer: Central Health Plan Commercial |
$96.67
|
| Rate for Payer: Cigna of CA HMO |
$77.34
|
| Rate for Payer: Cigna of CA PPO |
$89.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.34
|
| Rate for Payer: EPIC Health Plan Senior |
$48.34
|
| Rate for Payer: Galaxy Health WC |
$102.71
|
| Rate for Payer: Global Benefits Group Commercial |
$72.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$84.59
|
| Rate for Payer: Multiplan Commercial |
$90.63
|
| Rate for Payer: Networks By Design Commercial |
$78.55
|
| Rate for Payer: Prime Health Services Commercial |
$102.71
|
| Rate for Payer: Riverside University Health System MISP |
$48.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.42
|
| Rate for Payer: United Healthcare All Other HMO |
$60.42
|
| Rate for Payer: United Healthcare HMO Rider |
$60.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.71
|
| Rate for Payer: Vantage Medical Group Senior |
$102.71
|
|
|
HC SHEATH GLIDETHRU 5FR 7CM
|
Facility
|
IP
|
$114.76
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.95 |
| Max. Negotiated Rate |
$103.28 |
| Rate for Payer: Adventist Health Commercial |
$22.95
|
| Rate for Payer: Cash Price |
$51.64
|
| Rate for Payer: Central Health Plan Commercial |
$91.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.90
|
| Rate for Payer: EPIC Health Plan Senior |
$45.90
|
| Rate for Payer: Galaxy Health WC |
$97.55
|
| Rate for Payer: Global Benefits Group Commercial |
$68.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.95
|
| Rate for Payer: Multiplan Commercial |
$86.07
|
| Rate for Payer: Networks By Design Commercial |
$74.59
|
| Rate for Payer: Prime Health Services Commercial |
$97.55
|
|
|
HC SHEATH GLIDETHRU 5FR 7CM
|
Facility
|
OP
|
$114.76
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.95 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$22.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$97.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$86.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.76
|
| Rate for Payer: Blue Shield of California Commercial |
$72.76
|
| Rate for Payer: Blue Shield of California EPN |
$45.79
|
| Rate for Payer: Cash Price |
$51.64
|
| Rate for Payer: Cash Price |
$51.64
|
| Rate for Payer: Central Health Plan Commercial |
$91.81
|
| Rate for Payer: Cigna of CA HMO |
$73.45
|
| Rate for Payer: Cigna of CA PPO |
$84.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$97.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$97.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.90
|
| Rate for Payer: EPIC Health Plan Senior |
$45.90
|
| Rate for Payer: Galaxy Health WC |
$97.55
|
| Rate for Payer: Global Benefits Group Commercial |
$68.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$80.33
|
| Rate for Payer: Multiplan Commercial |
$86.07
|
| Rate for Payer: Networks By Design Commercial |
$74.59
|
| Rate for Payer: Prime Health Services Commercial |
$97.55
|
| Rate for Payer: Riverside University Health System MISP |
$45.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.38
|
| Rate for Payer: United Healthcare All Other HMO |
$57.38
|
| Rate for Payer: United Healthcare HMO Rider |
$57.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$97.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.55
|
| Rate for Payer: Vantage Medical Group Senior |
$97.55
|
|
|
HC SHEATH GLIDETHRU 6FR 7CM
|
Facility
|
IP
|
$111.72
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$100.55 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Central Health Plan Commercial |
$89.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.69
|
| Rate for Payer: EPIC Health Plan Senior |
$44.69
|
| Rate for Payer: Galaxy Health WC |
$94.96
|
| Rate for Payer: Global Benefits Group Commercial |
$67.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Multiplan Commercial |
$83.79
|
| Rate for Payer: Networks By Design Commercial |
$72.62
|
| Rate for Payer: Prime Health Services Commercial |
$94.96
|
|
|
HC SHEATH GLIDETHRU 6FR 7CM
|
Facility
|
OP
|
$111.72
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.99
|
| Rate for Payer: Blue Shield of California Commercial |
$70.83
|
| Rate for Payer: Blue Shield of California EPN |
$44.58
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Central Health Plan Commercial |
$89.38
|
| Rate for Payer: Cigna of CA HMO |
$71.50
|
| Rate for Payer: Cigna of CA PPO |
$82.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.69
|
| Rate for Payer: EPIC Health Plan Senior |
$44.69
|
| Rate for Payer: Galaxy Health WC |
$94.96
|
| Rate for Payer: Global Benefits Group Commercial |
$67.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$78.20
|
| Rate for Payer: Multiplan Commercial |
$83.79
|
| Rate for Payer: Networks By Design Commercial |
$72.62
|
| Rate for Payer: Prime Health Services Commercial |
$94.96
|
| Rate for Payer: Riverside University Health System MISP |
$44.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.86
|
| Rate for Payer: United Healthcare All Other HMO |
$55.86
|
| Rate for Payer: United Healthcare HMO Rider |
$55.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.96
|
| Rate for Payer: Vantage Medical Group Senior |
$94.96
|
|
|
HC SHEATH INTRODUCER KIT 8.5FR
|
Facility
|
OP
|
$639.63
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.93 |
| Max. Negotiated Rate |
$575.67 |
| Rate for Payer: Adventist Health Commercial |
$127.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$543.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$351.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$309.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$372.07
|
| Rate for Payer: Blue Shield of California Commercial |
$405.53
|
| Rate for Payer: Blue Shield of California EPN |
$255.21
|
| Rate for Payer: Cash Price |
$287.83
|
| Rate for Payer: Cash Price |
$287.83
|
| Rate for Payer: Central Health Plan Commercial |
$511.70
|
| Rate for Payer: Cigna of CA HMO |
$409.36
|
| Rate for Payer: Cigna of CA PPO |
$473.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$543.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$543.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$543.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$447.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.85
|
| Rate for Payer: EPIC Health Plan Senior |
$255.85
|
| Rate for Payer: Galaxy Health WC |
$543.69
|
| Rate for Payer: Global Benefits Group Commercial |
$383.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$575.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$406.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$377.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$447.74
|
| Rate for Payer: Multiplan Commercial |
$479.72
|
| Rate for Payer: Networks By Design Commercial |
$415.76
|
| Rate for Payer: Prime Health Services Commercial |
$543.69
|
| Rate for Payer: Riverside University Health System MISP |
$255.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$383.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$383.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.81
|
| Rate for Payer: United Healthcare All Other HMO |
$319.81
|
| Rate for Payer: United Healthcare HMO Rider |
$319.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$543.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$543.69
|
| Rate for Payer: Vantage Medical Group Senior |
$543.69
|
|
|
HC SHEATH INTRODUCER KIT 8.5FR
|
Facility
|
IP
|
$639.63
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.93 |
| Max. Negotiated Rate |
$575.67 |
| Rate for Payer: Adventist Health Commercial |
$127.93
|
| Rate for Payer: Cash Price |
$287.83
|
| Rate for Payer: Central Health Plan Commercial |
$511.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$447.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.85
|
| Rate for Payer: EPIC Health Plan Senior |
$255.85
|
| Rate for Payer: Galaxy Health WC |
$543.69
|
| Rate for Payer: Global Benefits Group Commercial |
$383.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$575.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$406.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$377.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.93
|
| Rate for Payer: Multiplan Commercial |
$479.72
|
| Rate for Payer: Networks By Design Commercial |
$415.76
|
| Rate for Payer: Prime Health Services Commercial |
$543.69
|
|
|
HC SHEATH INTRODUCER KIT 9FR
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$438.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$407.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$449.19
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
|
|
HC SHEATH INTRODUCER KIT 9FR
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$334.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$401.99
|
| Rate for Payer: Blue Shield of California Commercial |
$438.13
|
| Rate for Payer: Blue Shield of California EPN |
$275.73
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$442.28
|
| Rate for Payer: Cigna of CA PPO |
$511.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$438.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$250.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$407.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$449.19
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$345.53
|
| Rate for Payer: United Healthcare All Other HMO |
$345.53
|
| Rate for Payer: United Healthcare HMO Rider |
$345.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$345.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC SHEATH NEEDLE (COOK)
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909001044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.60 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$34.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$147.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.63
|
| Rate for Payer: Blue Shield of California Commercial |
$109.68
|
| Rate for Payer: Blue Shield of California EPN |
$69.03
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Central Health Plan Commercial |
$138.40
|
| Rate for Payer: Cigna of CA HMO |
$110.72
|
| Rate for Payer: Cigna of CA PPO |
$128.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$147.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$147.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.20
|
| Rate for Payer: EPIC Health Plan Senior |
$69.20
|
| Rate for Payer: Galaxy Health WC |
$147.05
|
| Rate for Payer: Global Benefits Group Commercial |
$103.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$102.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$129.75
|
| Rate for Payer: Networks By Design Commercial |
$112.45
|
| Rate for Payer: Prime Health Services Commercial |
$147.05
|
| Rate for Payer: Riverside University Health System MISP |
$69.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$86.50
|
| Rate for Payer: United Healthcare All Other HMO |
$86.50
|
| Rate for Payer: United Healthcare HMO Rider |
$86.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$147.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.05
|
| Rate for Payer: Vantage Medical Group Senior |
$147.05
|
|
|
HC SHEATH NEEDLE (COOK)
|
Facility
|
IP
|
$173.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909001044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.60 |
| Max. Negotiated Rate |
$155.70 |
| Rate for Payer: Adventist Health Commercial |
$34.60
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Central Health Plan Commercial |
$138.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.20
|
| Rate for Payer: EPIC Health Plan Senior |
$69.20
|
| Rate for Payer: Galaxy Health WC |
$147.05
|
| Rate for Payer: Global Benefits Group Commercial |
$103.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$102.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.60
|
| Rate for Payer: Multiplan Commercial |
$129.75
|
| Rate for Payer: Networks By Design Commercial |
$112.45
|
| Rate for Payer: Prime Health Services Commercial |
$147.05
|
|
|
HC SHEATH SET/11CM (COOK)
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.80
|
| Rate for Payer: Blue Shield of California Commercial |
$76.08
|
| Rate for Payer: Blue Shield of California EPN |
$47.88
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Riverside University Health System MISP |
$48.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.00
|
| Rate for Payer: United Healthcare All Other HMO |
$60.00
|
| Rate for Payer: United Healthcare HMO Rider |
$60.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$102.00
|
|
|
HC SHEATH SET/11CM (COOK)
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC SHEATH SET/30-80CM
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Adventist Health Commercial |
$50.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$190.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.75
|
| Rate for Payer: Blue Shield of California Commercial |
$161.04
|
| Rate for Payer: Blue Shield of California EPN |
$101.35
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Cigna of CA HMO |
$162.56
|
| Rate for Payer: Cigna of CA PPO |
$187.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$92.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$177.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
| Rate for Payer: Riverside University Health System MISP |
$101.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$127.00
|
| Rate for Payer: United Healthcare All Other HMO |
$127.00
|
| Rate for Payer: United Healthcare HMO Rider |
$127.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$127.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.90
|
| Rate for Payer: Vantage Medical Group Senior |
$215.90
|
|
|
HC SHEATH SET/30-80CM
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$228.60 |
| Rate for Payer: Adventist Health Commercial |
$50.80
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Central Health Plan Commercial |
$203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$101.60
|
| Rate for Payer: Galaxy Health WC |
$215.90
|
| Rate for Payer: Global Benefits Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$228.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$161.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.80
|
| Rate for Payer: Multiplan Commercial |
$190.50
|
| Rate for Payer: Networks By Design Commercial |
$165.10
|
| Rate for Payer: Prime Health Services Commercial |
$215.90
|
|
|
HC SHIGATOXIN
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 87427
|
| Hospital Charge Code |
900912326
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.90
|
| Rate for Payer: Blue Shield of California Commercial |
$62.37
|
| Rate for Payer: Blue Shield of California Commercial |
$117.18
|
| Rate for Payer: Blue Shield of California EPN |
$39.30
|
| Rate for Payer: Blue Shield of California EPN |
$73.84
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Central Health Plan Commercial |
$148.80
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA HMO |
$119.04
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Cigna of CA PPO |
$137.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.77
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Galaxy Health WC |
$158.10
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Global Benefits Group Commercial |
$111.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$167.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.65
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$118.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.05
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
| Rate for Payer: Networks By Design Commercial |
$120.90
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.98
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.98
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Prime Health Services Commercial |
$158.10
|
| Rate for Payer: Prime Health Services Medicare |
$12.70
|
| Rate for Payer: Prime Health Services Medicare |
$12.70
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
