|
HC SEWHO ERBS PALSY DESIGN
|
Facility
|
OP
|
$1,632.00
|
|
|
Service Code
|
CPT L3962
|
| Hospital Charge Code |
905353962
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$571.20 |
| Max. Negotiated Rate |
$1,468.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,387.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$897.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$897.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$964.19
|
| Rate for Payer: Blue Distinction Transplant |
$979.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,224.00
|
| Rate for Payer: Blue Shield of California EPN |
$887.81
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,305.60
|
| Rate for Payer: Cigna of CA HMO |
$1,142.40
|
| Rate for Payer: Cigna of CA PPO |
$1,142.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,387.20
|
| Rate for Payer: Dignity Health Media |
$1,387.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,387.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$652.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$652.80
|
| Rate for Payer: Galaxy Health WC |
$1,387.20
|
| Rate for Payer: Global Benefits Group Commercial |
$979.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,468.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,224.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$571.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,088.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$669.12
|
| Rate for Payer: Multiplan Commercial |
$1,224.00
|
| Rate for Payer: Networks By Design Commercial |
$816.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,387.20
|
| Rate for Payer: Riverside University Health System MISP |
$652.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Other HMO |
$816.00
|
| Rate for Payer: United Healthcare HMO Rider |
$816.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$816.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,387.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,387.20
|
|
|
HC SHAVE SKIN LESION 0.6 - 1.0 CM
|
Facility
|
OP
|
$490.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
900501790
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$260.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$294.00
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Central Health Plan Commercial |
$392.00
|
| Rate for Payer: Cigna of CA PPO |
$362.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$416.50
|
| Rate for Payer: Global Benefits Group Commercial |
$294.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$441.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$367.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$326.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$217.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$367.50
|
| Rate for Payer: Networks By Design Commercial |
$318.50
|
| Rate for Payer: Prime Health Services Commercial |
$416.50
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$294.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SHAVE SKIN LESION 0.6 - 1.0 CM
|
Facility
|
IP
|
$490.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
900501790
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$441.00 |
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Central Health Plan Commercial |
$392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$196.00
|
| Rate for Payer: Galaxy Health WC |
$416.50
|
| Rate for Payer: Global Benefits Group Commercial |
$294.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$441.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$326.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.00
|
| Rate for Payer: Multiplan Commercial |
$367.50
|
| Rate for Payer: Networks By Design Commercial |
$318.50
|
| Rate for Payer: Prime Health Services Commercial |
$416.50
|
|
|
HC SHAVING LESION SCLP NCK HND FT GEN LT 0.5CM
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
902890369
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Central Health Plan Commercial |
$304.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.00
|
| Rate for Payer: Galaxy Health WC |
$323.00
|
| Rate for Payer: Global Benefits Group Commercial |
$228.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$342.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$253.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.00
|
| Rate for Payer: Multiplan Commercial |
$285.00
|
| Rate for Payer: Networks By Design Commercial |
$247.00
|
| Rate for Payer: Prime Health Services Commercial |
$323.00
|
|
|
HC SHAVING LESION SCLP NCK HND FT GEN LT 0.5CM
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
902890369
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$48.81 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$172.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$228.00
|
| Rate for Payer: Blue Shield of California Commercial |
$239.02
|
| Rate for Payer: Blue Shield of California EPN |
$185.82
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Central Health Plan Commercial |
$304.00
|
| Rate for Payer: Cigna of CA HMO |
$243.20
|
| Rate for Payer: Cigna of CA PPO |
$281.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$323.00
|
| Rate for Payer: Global Benefits Group Commercial |
$228.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$342.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$285.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$253.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$285.00
|
| Rate for Payer: Networks By Design Commercial |
$247.00
|
| Rate for Payer: Prime Health Services Commercial |
$323.00
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$228.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$228.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$190.00
|
| Rate for Payer: United Healthcare All Other HMO |
$190.00
|
| Rate for Payer: United Healthcare HMO Rider |
$190.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
OP
|
$567.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$340.20
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Central Health Plan Commercial |
$453.60
|
| Rate for Payer: Cigna of CA PPO |
$419.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$481.95
|
| Rate for Payer: Global Benefits Group Commercial |
$340.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$510.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$425.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$378.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$425.25
|
| Rate for Payer: Networks By Design Commercial |
$368.55
|
| Rate for Payer: Prime Health Services Commercial |
$481.95
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$340.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$283.50
|
| Rate for Payer: United Healthcare All Other HMO |
$283.50
|
| Rate for Payer: United Healthcare HMO Rider |
$283.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$283.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
IP
|
$567.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$510.30 |
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Central Health Plan Commercial |
$453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.80
|
| Rate for Payer: Galaxy Health WC |
$481.95
|
| Rate for Payer: Global Benefits Group Commercial |
$340.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$510.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$378.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.40
|
| Rate for Payer: Multiplan Commercial |
$425.25
|
| Rate for Payer: Networks By Design Commercial |
$368.55
|
| Rate for Payer: Prime Health Services Commercial |
$481.95
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
OP
|
$567.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$221.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$340.20
|
| Rate for Payer: Blue Shield of California Commercial |
$356.64
|
| Rate for Payer: Blue Shield of California EPN |
$277.26
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Central Health Plan Commercial |
$453.60
|
| Rate for Payer: Cigna of CA HMO |
$362.88
|
| Rate for Payer: Cigna of CA PPO |
$419.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$481.95
|
| Rate for Payer: Global Benefits Group Commercial |
$340.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$510.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$425.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$378.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$425.25
|
| Rate for Payer: Networks By Design Commercial |
$368.55
|
| Rate for Payer: Prime Health Services Commercial |
$481.95
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$340.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$340.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$283.50
|
| Rate for Payer: United Healthcare All Other HMO |
$283.50
|
| Rate for Payer: United Healthcare HMO Rider |
$283.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$283.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SHAVING SKIN LESION .5CM OR LT
|
Facility
|
IP
|
$567.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
900501338
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$510.30 |
| Rate for Payer: Cash Price |
$255.15
|
| Rate for Payer: Central Health Plan Commercial |
$453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.80
|
| Rate for Payer: Galaxy Health WC |
$481.95
|
| Rate for Payer: Global Benefits Group Commercial |
$340.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$510.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$378.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.40
|
| Rate for Payer: Multiplan Commercial |
$425.25
|
| Rate for Payer: Networks By Design Commercial |
$368.55
|
| Rate for Payer: Prime Health Services Commercial |
$481.95
|
|
|
HC SHEATH GLIDETHRU 4.5FR 7CM
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.98
|
| Rate for Payer: Blue Distinction Transplant |
$61.93
|
| Rate for Payer: Blue Shield of California Commercial |
$64.92
|
| Rate for Payer: Blue Shield of California EPN |
$50.47
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: Cigna of CA HMO |
$66.05
|
| Rate for Payer: Cigna of CA PPO |
$76.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.73
|
| Rate for Payer: Dignity Health Media |
$87.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
| Rate for Payer: Riverside University Health System MISP |
$41.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.60
|
| Rate for Payer: United Healthcare HMO Rider |
$51.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.73
|
| Rate for Payer: Vantage Medical Group Senior |
$87.73
|
|
|
HC SHEATH GLIDETHRU 4.5FR 7CM
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607733
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
|
|
HC SHEATH GLIDETHRU 4FR 7CM
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.98
|
| Rate for Payer: Blue Distinction Transplant |
$61.93
|
| Rate for Payer: Blue Shield of California Commercial |
$64.92
|
| Rate for Payer: Blue Shield of California EPN |
$50.47
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: Cigna of CA HMO |
$66.05
|
| Rate for Payer: Cigna of CA PPO |
$76.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.73
|
| Rate for Payer: Dignity Health Media |
$87.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
| Rate for Payer: Riverside University Health System MISP |
$41.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.60
|
| Rate for Payer: United Healthcare HMO Rider |
$51.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.73
|
| Rate for Payer: Vantage Medical Group Senior |
$87.73
|
|
|
HC SHEATH GLIDETHRU 4FR 7CM
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
|
|
HC SHEATH GLIDETHRU 5.5FR 7CM
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607735
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
|
|
HC SHEATH GLIDETHRU 5.5FR 7CM
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607735
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.98
|
| Rate for Payer: Blue Distinction Transplant |
$61.93
|
| Rate for Payer: Blue Shield of California Commercial |
$64.92
|
| Rate for Payer: Blue Shield of California EPN |
$50.47
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: Cigna of CA HMO |
$66.05
|
| Rate for Payer: Cigna of CA PPO |
$76.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.73
|
| Rate for Payer: Dignity Health Media |
$87.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
| Rate for Payer: Riverside University Health System MISP |
$41.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.60
|
| Rate for Payer: United Healthcare HMO Rider |
$51.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.73
|
| Rate for Payer: Vantage Medical Group Senior |
$87.73
|
|
|
HC SHEATH GLIDETHRU 5FR 7CM
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
|
|
HC SHEATH GLIDETHRU 5FR 7CM
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.98
|
| Rate for Payer: Blue Distinction Transplant |
$61.93
|
| Rate for Payer: Blue Shield of California Commercial |
$64.92
|
| Rate for Payer: Blue Shield of California EPN |
$50.47
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: Cigna of CA HMO |
$66.05
|
| Rate for Payer: Cigna of CA PPO |
$76.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.73
|
| Rate for Payer: Dignity Health Media |
$87.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
| Rate for Payer: Riverside University Health System MISP |
$41.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.60
|
| Rate for Payer: United Healthcare HMO Rider |
$51.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.73
|
| Rate for Payer: Vantage Medical Group Senior |
$87.73
|
|
|
HC SHEATH GLIDETHRU 6FR 7CM
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
|
|
HC SHEATH GLIDETHRU 6FR 7CM
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901607736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.98
|
| Rate for Payer: Blue Distinction Transplant |
$61.93
|
| Rate for Payer: Blue Shield of California Commercial |
$64.92
|
| Rate for Payer: Blue Shield of California EPN |
$50.47
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Cash Price |
$46.44
|
| Rate for Payer: Central Health Plan Commercial |
$82.57
|
| Rate for Payer: Cigna of CA HMO |
$66.05
|
| Rate for Payer: Cigna of CA PPO |
$76.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.73
|
| Rate for Payer: Dignity Health Media |
$87.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$87.73
|
| Rate for Payer: Global Benefits Group Commercial |
$61.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$77.41
|
| Rate for Payer: Networks By Design Commercial |
$67.09
|
| Rate for Payer: Prime Health Services Commercial |
$87.73
|
| Rate for Payer: Riverside University Health System MISP |
$41.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.60
|
| Rate for Payer: United Healthcare HMO Rider |
$51.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.73
|
| Rate for Payer: Vantage Medical Group Senior |
$87.73
|
|
|
HC SHEATH INTRODUCER KIT 8.5FR
|
Facility
|
OP
|
$638.89
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.78 |
| Max. Negotiated Rate |
$575.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$543.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$351.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$309.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$377.46
|
| Rate for Payer: Blue Distinction Transplant |
$383.33
|
| Rate for Payer: Blue Shield of California Commercial |
$401.86
|
| Rate for Payer: Blue Shield of California EPN |
$312.42
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Central Health Plan Commercial |
$511.11
|
| Rate for Payer: Cigna of CA HMO |
$408.89
|
| Rate for Payer: Cigna of CA PPO |
$472.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$543.06
|
| Rate for Payer: Dignity Health Media |
$543.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$543.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$255.56
|
| Rate for Payer: Galaxy Health WC |
$543.06
|
| Rate for Payer: Global Benefits Group Commercial |
$383.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$575.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$479.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$223.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$426.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.78
|
| Rate for Payer: Multiplan Commercial |
$479.17
|
| Rate for Payer: Networks By Design Commercial |
$415.28
|
| Rate for Payer: Prime Health Services Commercial |
$543.06
|
| Rate for Payer: Riverside University Health System MISP |
$255.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$383.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$383.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$319.44
|
| Rate for Payer: United Healthcare All Other HMO |
$319.44
|
| Rate for Payer: United Healthcare HMO Rider |
$319.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$543.06
|
| Rate for Payer: Vantage Medical Group Senior |
$543.06
|
|
|
HC SHEATH INTRODUCER KIT 8.5FR
|
Facility
|
IP
|
$638.89
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.78 |
| Max. Negotiated Rate |
$575.00 |
| Rate for Payer: Cash Price |
$287.50
|
| Rate for Payer: Central Health Plan Commercial |
$511.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.56
|
| Rate for Payer: Galaxy Health WC |
$543.06
|
| Rate for Payer: Global Benefits Group Commercial |
$383.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$575.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$426.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.78
|
| Rate for Payer: Multiplan Commercial |
$479.17
|
| Rate for Payer: Networks By Design Commercial |
$415.28
|
| Rate for Payer: Prime Health Services Commercial |
$543.06
|
|
|
HC SHEATH INTRODUCER KIT 9FR
|
Facility
|
IP
|
$690.41
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.08 |
| Max. Negotiated Rate |
$621.37 |
| Rate for Payer: Cash Price |
$310.68
|
| Rate for Payer: Central Health Plan Commercial |
$552.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.16
|
| Rate for Payer: Galaxy Health WC |
$586.85
|
| Rate for Payer: Global Benefits Group Commercial |
$414.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.08
|
| Rate for Payer: Multiplan Commercial |
$517.81
|
| Rate for Payer: Networks By Design Commercial |
$448.77
|
| Rate for Payer: Prime Health Services Commercial |
$586.85
|
|
|
HC SHEATH INTRODUCER KIT 9FR
|
Facility
|
OP
|
$690.41
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698535
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.08 |
| Max. Negotiated Rate |
$621.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$586.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$379.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$379.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$334.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$407.89
|
| Rate for Payer: Blue Distinction Transplant |
$414.25
|
| Rate for Payer: Blue Shield of California Commercial |
$434.27
|
| Rate for Payer: Blue Shield of California EPN |
$337.61
|
| Rate for Payer: Cash Price |
$310.68
|
| Rate for Payer: Cash Price |
$310.68
|
| Rate for Payer: Central Health Plan Commercial |
$552.33
|
| Rate for Payer: Cigna of CA HMO |
$441.86
|
| Rate for Payer: Cigna of CA PPO |
$510.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$586.85
|
| Rate for Payer: Dignity Health Media |
$586.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$586.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$276.16
|
| Rate for Payer: Galaxy Health WC |
$586.85
|
| Rate for Payer: Global Benefits Group Commercial |
$414.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.37
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$517.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$241.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.08
|
| Rate for Payer: Multiplan Commercial |
$517.81
|
| Rate for Payer: Networks By Design Commercial |
$448.77
|
| Rate for Payer: Prime Health Services Commercial |
$586.85
|
| Rate for Payer: Riverside University Health System MISP |
$276.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$345.20
|
| Rate for Payer: United Healthcare All Other HMO |
$345.20
|
| Rate for Payer: United Healthcare HMO Rider |
$345.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$345.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$586.85
|
| Rate for Payer: Vantage Medical Group Senior |
$586.85
|
|
|
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: Cash Price |
$77.85
|
| Rate for Payer: Central Health Plan Commercial |
$138.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$115.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.91
|
| 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 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: 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 |
$95.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.21
|
| Rate for Payer: Blue Distinction Transplant |
$103.80
|
| Rate for Payer: Blue Shield of California Commercial |
$108.82
|
| Rate for Payer: Blue Shield of California EPN |
$84.60
|
| 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 Media |
$147.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$129.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$60.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$115.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.91
|
| 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
|
| 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 Medi-Cal |
$147.05
|
| Rate for Payer: Vantage Medical Group Senior |
$147.05
|
|
