|
HC CATH CNTRL VNS 5FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH CNTRL VNS 5FR8CM DL BRK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH CNTRL VNS 5FR8CM DL BRK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH CNTRL VNS 7FR TL
|
Facility
|
IP
|
$233.94
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.79 |
| Max. Negotiated Rate |
$198.85 |
| Rate for Payer: Adventist Health Commercial |
$46.79
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.58
|
| Rate for Payer: EPIC Health Plan Senior |
$93.58
|
| Rate for Payer: Galaxy Health WC |
$198.85
|
| Rate for Payer: Global Benefits Group Commercial |
$140.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.15
|
| Rate for Payer: Multiplan Commercial |
$187.15
|
| Rate for Payer: Networks By Design Commercial |
$152.06
|
| Rate for Payer: Prime Health Services Commercial |
$198.85
|
|
|
HC CATH CNTRL VNS 7FR TL
|
Facility
|
OP
|
$233.94
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.79 |
| Max. Negotiated Rate |
$198.85 |
| Rate for Payer: Adventist Health Commercial |
$46.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$198.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.66
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cigna of CA HMO |
$149.72
|
| Rate for Payer: Cigna of CA PPO |
$173.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$198.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.58
|
| Rate for Payer: EPIC Health Plan Senior |
$93.58
|
| Rate for Payer: Galaxy Health WC |
$198.85
|
| Rate for Payer: Global Benefits Group Commercial |
$140.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.76
|
| Rate for Payer: Multiplan Commercial |
$187.15
|
| Rate for Payer: Networks By Design Commercial |
$152.06
|
| Rate for Payer: Prime Health Services Commercial |
$198.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$140.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$140.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.97
|
| Rate for Payer: United Healthcare All Other HMO |
$116.97
|
| Rate for Payer: United Healthcare HMO Rider |
$116.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$198.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.85
|
| Rate for Payer: Vantage Medical Group Senior |
$198.85
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
OP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$2,391.47 |
| Rate for Payer: Adventist Health Commercial |
$562.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,547.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,110.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,629.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,076.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,367.36
|
| Rate for Payer: Cash Price |
$1,266.08
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,391.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,391.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,741.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$675.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,969.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,969.45
|
| Rate for Payer: Multiplan Commercial |
$2,250.80
|
| Rate for Payer: Networks By Design Commercial |
$1,406.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,688.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,688.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,055.91
|
| Rate for Payer: United Healthcare All Other HMO |
$1,027.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,005.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$921.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$2,391.47
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
IP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$562.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,266.08
|
| Rate for Payer: Cash Price |
$1,266.08
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,741.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$675.24
|
| Rate for Payer: Multiplan Commercial |
$2,250.80
|
| Rate for Payer: Networks By Design Commercial |
$1,406.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,055.91
|
| Rate for Payer: United Healthcare All Other HMO |
$1,027.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,005.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$921.42
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
IP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$248.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$559.89
|
| Rate for Payer: Cash Price |
$559.89
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Senior |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$770.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.61
|
| Rate for Payer: Multiplan Commercial |
$995.37
|
| Rate for Payer: Networks By Design Commercial |
$622.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.95
|
| Rate for Payer: United Healthcare All Other HMO |
$454.51
|
| Rate for Payer: United Healthcare HMO Rider |
$444.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.48
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
OP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$1,057.58 |
| Rate for Payer: Adventist Health Commercial |
$248.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$684.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$933.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$720.65
|
| Rate for Payer: Blue Shield of California Commercial |
$918.23
|
| Rate for Payer: Blue Shield of California EPN |
$604.69
|
| Rate for Payer: Cash Price |
$559.89
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,057.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,057.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Senior |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$770.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$298.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$870.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$870.95
|
| Rate for Payer: Multiplan Commercial |
$995.37
|
| Rate for Payer: Networks By Design Commercial |
$622.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$746.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$746.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.95
|
| Rate for Payer: United Healthcare All Other HMO |
$454.51
|
| Rate for Payer: United Healthcare HMO Rider |
$444.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,057.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,057.58
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
IP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$186.83 |
| Rate for Payer: Adventist Health Commercial |
$43.96
|
| Rate for Payer: Cash Price |
$98.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: EPIC Health Plan Senior |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.75
|
| Rate for Payer: Multiplan Commercial |
$175.84
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
OP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$186.83 |
| Rate for Payer: Adventist Health Commercial |
$43.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$186.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.98
|
| Rate for Payer: Cash Price |
$98.91
|
| Rate for Payer: Cigna of CA HMO |
$140.67
|
| Rate for Payer: Cigna of CA PPO |
$162.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$186.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: EPIC Health Plan Senior |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.86
|
| Rate for Payer: Multiplan Commercial |
$175.84
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.90
|
| Rate for Payer: United Healthcare All Other HMO |
$109.90
|
| Rate for Payer: United Healthcare HMO Rider |
$109.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$186.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.83
|
| Rate for Payer: Vantage Medical Group Senior |
$186.83
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,697.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,117.80
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
OP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$534.77 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$412.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$471.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$386.35
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Cigna of CA HMO |
$402.65
|
| Rate for Payer: Cigna of CA PPO |
$465.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$534.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$440.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$440.40
|
| Rate for Payer: Multiplan Commercial |
$503.31
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$377.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.57
|
| Rate for Payer: United Healthcare All Other HMO |
$314.57
|
| Rate for Payer: United Healthcare HMO Rider |
$314.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.77
|
| Rate for Payer: Vantage Medical Group Senior |
$534.77
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
IP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$534.77 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.99
|
| Rate for Payer: Multiplan Commercial |
$503.31
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$376.65 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.66
|
| Rate for Payer: Blue Shield of California Commercial |
$327.02
|
| Rate for Payer: Blue Shield of California EPN |
$215.36
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$310.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$354.50
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS KIT DL PEDS 5FR
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.35
|
| Rate for Payer: Multiplan Commercial |
$354.50
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$376.65 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$243.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$332.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.66
|
| Rate for Payer: Blue Shield of California Commercial |
$327.02
|
| Rate for Payer: Blue Shield of California EPN |
$215.36
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$376.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$376.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$376.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$310.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$310.18
|
| Rate for Payer: Multiplan Commercial |
$354.50
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$265.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$376.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$376.65
|
| Rate for Payer: Vantage Medical Group Senior |
$376.65
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$443.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.62 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$88.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cash Price |
$199.40
|
| Rate for Payer: Cigna of CA HMO |
$310.18
|
| Rate for Payer: Cigna of CA PPO |
$310.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.25
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$376.65
|
| Rate for Payer: Global Benefits Group Commercial |
$265.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$295.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$274.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.35
|
| Rate for Payer: Multiplan Commercial |
$354.50
|
| Rate for Payer: Networks By Design Commercial |
$221.56
|
| Rate for Payer: Prime Health Services Commercial |
$376.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.30
|
| Rate for Payer: United Healthcare All Other HMO |
$161.87
|
| Rate for Payer: United Healthcare HMO Rider |
$158.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.12
|
|
|
HC CATH CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.72
|
| Rate for Payer: Blue Shield of California Commercial |
$258.30
|
| Rate for Payer: Blue Shield of California EPN |
$170.10
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH CNTRL VNS SET 5FR 1LUMEN
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698847
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
|
|
HC CATH CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
IP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$395.37
|
| Rate for Payer: Cash Price |
$395.37
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.86
|
| Rate for Payer: Multiplan Commercial |
$702.88
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
|
|
HC CATH CNTRL VNS SET/TRAY 4FR DL
|
Facility
|
OP
|
$878.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698836
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.72 |
| Max. Negotiated Rate |
$746.81 |
| Rate for Payer: Adventist Health Commercial |
$175.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$658.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$508.89
|
| Rate for Payer: Blue Shield of California Commercial |
$648.41
|
| Rate for Payer: Blue Shield of California EPN |
$427.00
|
| Rate for Payer: Cash Price |
$395.37
|
| Rate for Payer: Cigna of CA HMO |
$615.02
|
| Rate for Payer: Cigna of CA PPO |
$615.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$746.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$746.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.44
|
| Rate for Payer: EPIC Health Plan Senior |
$351.44
|
| Rate for Payer: Galaxy Health WC |
$746.81
|
| Rate for Payer: Global Benefits Group Commercial |
$527.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$615.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$615.02
|
| Rate for Payer: Multiplan Commercial |
$702.88
|
| Rate for Payer: Networks By Design Commercial |
$439.30
|
| Rate for Payer: Prime Health Services Commercial |
$746.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$329.74
|
| Rate for Payer: United Healthcare All Other HMO |
$320.95
|
| Rate for Payer: United Healthcare HMO Rider |
$314.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$746.81
|
| Rate for Payer: Vantage Medical Group Senior |
$746.81
|
|
