|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$3,979.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$795.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,733.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,188.45
|
| Rate for Payer: Cash Price |
$2,188.45
|
| Rate for Payer: Cash Price |
$2,188.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,586.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Senior |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,999.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,693.78
|
| Rate for Payer: Heritage Provider Network Senior |
$2,693.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,897.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$720.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$994.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,039.00
|
| Rate for Payer: Multiplan Commercial |
$2,984.25
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,431.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,317.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,198.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$940.84 |
| Max. Negotiated Rate |
$3,898.50 |
| Rate for Payer: Adventist Health Commercial |
$1,039.60
|
| Rate for Payer: Cash Price |
$2,858.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,519.05
|
| Rate for Payer: Heritage Provider Network Senior |
$3,519.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$940.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,299.50
|
| Rate for Payer: Multiplan Commercial |
$3,898.50
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$23,333.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,223.27 |
| Max. Negotiated Rate |
$17,499.75 |
| Rate for Payer: Adventist Health Commercial |
$4,666.60
|
| Rate for Payer: Cash Price |
$12,833.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,796.44
|
| Rate for Payer: Heritage Provider Network Senior |
$15,796.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,223.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,833.25
|
| Rate for Payer: Multiplan Commercial |
$17,499.75
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,542.04 |
| Max. Negotiated Rate |
$22,964.25 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Cash Price |
$16,840.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,729.06
|
| Rate for Payer: Heritage Provider Network Senior |
$20,729.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,542.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,654.75
|
| Rate for Payer: Multiplan Commercial |
$22,964.25
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$23,333.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$489.14 |
| Max. Negotiated Rate |
$19,833.05 |
| Rate for Payer: Adventist Health Commercial |
$4,666.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,029.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,833.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,833.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,499.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$12,833.15
|
| Rate for Payer: Cash Price |
$12,833.15
|
| Rate for Payer: Cash Price |
$12,833.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,166.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,833.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,833.05
|
| Rate for Payer: Dignity Health Senior |
$19,833.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,443.13
|
| Rate for Payer: Heritage Provider Network Senior |
$14,443.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$489.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,129.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,223.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,833.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,333.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,333.10
|
| Rate for Payer: Multiplan Commercial |
$17,499.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,833.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,833.05
|
| Rate for Payer: Vantage Medical Group Senior |
$19,833.05
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$489.14 |
| Max. Negotiated Rate |
$26,026.15 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21,035.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,840.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,964.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$16,840.45
|
| Rate for Payer: Cash Price |
$16,840.45
|
| Rate for Payer: Cash Price |
$16,840.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19,902.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,026.15
|
| Rate for Payer: Dignity Health Senior |
$26,026.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,953.16
|
| Rate for Payer: Heritage Provider Network Senior |
$18,953.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$489.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14,605.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,542.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,654.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,433.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,433.30
|
| Rate for Payer: Multiplan Commercial |
$22,964.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Senior |
$26,026.15
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
OP
|
$10,810.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$2,162.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,426.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,945.50
|
| Rate for Payer: Cash Price |
$5,945.50
|
| Rate for Payer: Cash Price |
$5,945.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,026.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,691.39
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$316.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,956.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,702.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$8,107.50
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
IP
|
$10,810.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,956.61 |
| Max. Negotiated Rate |
$8,107.50 |
| Rate for Payer: Adventist Health Commercial |
$2,162.00
|
| Rate for Payer: Cash Price |
$5,945.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,318.37
|
| Rate for Payer: Heritage Provider Network Senior |
$7,318.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,956.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,702.50
|
| Rate for Payer: Multiplan Commercial |
$8,107.50
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
OP
|
$9,262.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$1,852.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,362.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,094.10
|
| Rate for Payer: Cash Price |
$5,094.10
|
| Rate for Payer: Cash Price |
$5,094.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,020.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Senior |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,484.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,733.18
|
| Rate for Payer: Heritage Provider Network Senior |
$5,515.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$971.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8,519.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,676.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,315.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,649.87
|
| Rate for Payer: Multiplan Commercial |
$6,946.50
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,932.42
|
| Rate for Payer: TriValley Medical Group Senior |
$4,932.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
IP
|
$9,262.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,676.42 |
| Max. Negotiated Rate |
$6,946.50 |
| Rate for Payer: Adventist Health Commercial |
$1,852.40
|
| Rate for Payer: Cash Price |
$5,094.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,270.37
|
| Rate for Payer: Heritage Provider Network Senior |
$6,270.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,676.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,315.50
|
| Rate for Payer: Multiplan Commercial |
$6,946.50
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
OP
|
$7,359.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,471.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,055.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$4,047.45
|
| Rate for Payer: Cash Price |
$4,047.45
|
| Rate for Payer: Cash Price |
$4,047.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,783.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,982.04
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,510.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,331.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,839.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$5,519.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,647.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,436.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
IP
|
$7,359.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,331.98 |
| Max. Negotiated Rate |
$5,519.25 |
| Rate for Payer: Adventist Health Commercial |
$1,471.80
|
| Rate for Payer: Cash Price |
$4,047.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,982.04
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,331.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,839.75
|
| Rate for Payer: Multiplan Commercial |
$5,519.25
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$58,366.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$40,097.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,128.55
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$824.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$75,675.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906820004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$77,401.14 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51,988.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,737.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$49,188.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,811.18
|
| Rate for Payer: Dignity Health Senior |
$40,737.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,103.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$40,737.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,842.82
|
| Rate for Payer: Heritage Provider Network Senior |
$50,107.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$824.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,737.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$77,401.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,848.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,329.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,329.17
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
| Rate for Payer: Multiplan WC |
$64,907.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$44,811.18
|
| Rate for Payer: TriValley Medical Group Senior |
$44,811.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66,017.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55,527.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,106.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,811.18
|
| Rate for Payer: Vantage Medical Group Senior |
$40,737.44
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$75,675.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906820004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,697.17 |
| Max. Negotiated Rate |
$56,756.25 |
| Rate for Payer: Adventist Health Commercial |
$15,135.00
|
| Rate for Payer: Cash Price |
$41,621.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$51,231.97
|
| Rate for Payer: Heritage Provider Network Senior |
$51,231.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,697.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,918.75
|
| Rate for Payer: Multiplan Commercial |
$56,756.25
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$58,366.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,564.25 |
| Max. Negotiated Rate |
$43,774.50 |
| Rate for Payer: Adventist Health Commercial |
$11,673.20
|
| Rate for Payer: Cash Price |
$32,101.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,513.78
|
| Rate for Payer: Heritage Provider Network Senior |
$39,513.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,564.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,591.50
|
| Rate for Payer: Multiplan Commercial |
$43,774.50
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
IP
|
$6,744.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,220.66 |
| Max. Negotiated Rate |
$5,058.00 |
| Rate for Payer: Adventist Health Commercial |
$1,348.80
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,565.69
|
| Rate for Payer: Heritage Provider Network Senior |
$4,565.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,220.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,686.00
|
| Rate for Payer: Multiplan Commercial |
$5,058.00
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
OP
|
$6,744.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,348.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,633.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,383.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Senior |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,602.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,174.54
|
| Rate for Payer: Heritage Provider Network Senior |
$3,201.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$446.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,945.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,220.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,993.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,686.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,279.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,279.58
|
| Rate for Payer: Multiplan Commercial |
$5,058.00
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,863.12
|
| Rate for Payer: TriValley Medical Group Senior |
$2,863.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,352.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$470.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,615.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Senior |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,528.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,973.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,455.89
|
| Rate for Payer: Heritage Provider Network Senior |
$2,427.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,750.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$425.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,269.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,486.99
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,171.18
|
| Rate for Payer: TriValley Medical Group Senior |
$1,973.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$361.82 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$499.75
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$361.82 |
| Max. Negotiated Rate |
$1,499.25 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,353.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,353.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$499.75
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$6,004.00 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,373.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,299.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Senior |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,299.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,973.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,353.32
|
| Rate for Payer: Heritage Provider Network Senior |
$1,353.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$953.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,269.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$499.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,486.99
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$719.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$661.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,352.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906820056
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$425.71 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$470.40
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$425.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.00
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$1,999.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$399.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,373.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cash Price |
$1,099.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Senior |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,299.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,973.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,237.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,427.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,750.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,269.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$499.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,486.99
|
| Rate for Payer: Multiplan Commercial |
$1,499.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,171.18
|
| Rate for Payer: TriValley Medical Group Senior |
$1,973.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$602.25 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Cash Price |
$441.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$543.63
|
| Rate for Payer: Heritage Provider Network Senior |
$543.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.75
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
|
