|
HC CATH MED TRAILBLAZER ANGLE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH MED TRAILBLAZER STRAIGHT
|
Facility
|
OP
|
$3,120.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$2,652.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,716.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,340.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,807.10
|
| Rate for Payer: Blue Shield of California Commercial |
$2,302.56
|
| Rate for Payer: Blue Shield of California EPN |
$1,516.32
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cigna of CA HMO |
$2,184.00
|
| Rate for Payer: Cigna of CA PPO |
$2,184.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,652.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,652.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,248.00
|
| Rate for Payer: Galaxy Health WC |
$2,652.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,872.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,184.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,184.00
|
| Rate for Payer: Multiplan Commercial |
$2,496.00
|
| Rate for Payer: Networks By Design Commercial |
$1,560.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,652.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,872.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,872.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,170.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,139.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,021.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,652.00
|
|
|
HC CATH MED TRAILBLAZER STRAIGHT
|
Facility
|
IP
|
$3,120.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Cigna of CA HMO |
$2,184.00
|
| Rate for Payer: Cigna of CA PPO |
$2,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,248.00
|
| Rate for Payer: Galaxy Health WC |
$2,652.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,872.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$748.80
|
| Rate for Payer: Multiplan Commercial |
$2,496.00
|
| Rate for Payer: Networks By Design Commercial |
$1,560.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,652.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,170.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,139.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,021.80
|
|
|
HC CATH MED VIANCE CROSSING
|
Facility
|
IP
|
$4,355.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$871.00 |
| Max. Negotiated Rate |
$3,701.75 |
| Rate for Payer: Adventist Health Commercial |
$871.00
|
| Rate for Payer: Cash Price |
$1,959.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,742.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,742.00
|
| Rate for Payer: Galaxy Health WC |
$3,701.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,613.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,904.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,659.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,695.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.20
|
| Rate for Payer: Multiplan Commercial |
$3,484.00
|
| Rate for Payer: Networks By Design Commercial |
$2,830.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,701.75
|
|
|
HC CATH MED VIANCE CROSSING
|
Facility
|
OP
|
$4,355.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812659
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$871.00 |
| Max. Negotiated Rate |
$3,701.75 |
| Rate for Payer: Adventist Health Commercial |
$871.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,856.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,395.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,266.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,674.41
|
| Rate for Payer: Cash Price |
$1,959.75
|
| Rate for Payer: Cigna of CA HMO |
$2,787.20
|
| Rate for Payer: Cigna of CA PPO |
$3,222.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,701.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,701.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,742.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,742.00
|
| Rate for Payer: Galaxy Health WC |
$3,701.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,613.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,904.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,659.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,695.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,048.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,048.50
|
| Rate for Payer: Multiplan Commercial |
$3,484.00
|
| Rate for Payer: Networks By Design Commercial |
$2,830.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,701.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,613.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,613.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,177.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,177.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,177.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,177.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,701.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,701.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,701.75
|
|
|
HC CATH MERIT MOD V
|
Facility
|
OP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.01
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Cigna of CA HMO |
$65.66
|
| Rate for Payer: Cigna of CA PPO |
$75.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.82
|
| Rate for Payer: Multiplan Commercial |
$82.08
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.30
|
| Rate for Payer: United Healthcare All Other HMO |
$51.30
|
| Rate for Payer: United Healthcare HMO Rider |
$51.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.21
|
| Rate for Payer: Vantage Medical Group Senior |
$87.21
|
|
|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.62
|
| Rate for Payer: Multiplan Commercial |
$82.08
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
IP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$55.17
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
OP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.35
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: Cigna of CA HMO |
$44.13
|
| Rate for Payer: Cigna of CA PPO |
$51.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.27
|
| Rate for Payer: Multiplan Commercial |
$55.17
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.48
|
| Rate for Payer: United Healthcare All Other HMO |
$34.48
|
| Rate for Payer: United Healthcare HMO Rider |
$34.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.62
|
| Rate for Payer: Vantage Medical Group Senior |
$58.62
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 3FR 20CM SL CDC
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
IP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$658.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.44
|
| Rate for Payer: Multiplan Commercial |
$851.48
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
OP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$904.70 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$616.47
|
| Rate for Payer: Blue Shield of California Commercial |
$785.49
|
| Rate for Payer: Blue Shield of California EPN |
$517.27
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$904.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$904.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$904.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$658.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.04
|
| Rate for Payer: Multiplan Commercial |
$851.48
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$638.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$638.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$904.70
|
| Rate for Payer: Vantage Medical Group Senior |
$904.70
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
IP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$450.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.51
|
| Rate for Payer: Multiplan Commercial |
$581.70
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
OP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$618.05 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$545.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.15
|
| Rate for Payer: Blue Shield of California Commercial |
$536.61
|
| Rate for Payer: Blue Shield of California EPN |
$353.38
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$618.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$618.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$618.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$450.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.98
|
| Rate for Payer: Multiplan Commercial |
$581.70
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$436.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$618.05
|
| Rate for Payer: Vantage Medical Group Senior |
$618.05
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
IP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.63
|
| Rate for Payer: Multiplan Commercial |
$618.75
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
OP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$657.42 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.98
|
| Rate for Payer: Blue Shield of California Commercial |
$570.80
|
| Rate for Payer: Blue Shield of California EPN |
$375.89
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.41
|
| Rate for Payer: Multiplan Commercial |
$618.75
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.42
|
| Rate for Payer: Vantage Medical Group Senior |
$657.42
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
OP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$458.26
|
| Rate for Payer: Blue Shield of California Commercial |
$583.91
|
| Rate for Payer: Blue Shield of California EPN |
$384.52
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$553.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
IP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
IP
|
$831.82
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.36 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$166.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cigna of CA HMO |
$582.27
|
| Rate for Payer: Cigna of CA PPO |
$582.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.73
|
| Rate for Payer: EPIC Health Plan Senior |
$332.73
|
| Rate for Payer: Galaxy Health WC |
$707.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$554.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$514.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Multiplan Commercial |
$665.46
|
| Rate for Payer: Networks By Design Commercial |
$415.91
|
| Rate for Payer: Prime Health Services Commercial |
$707.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$312.18
|
| Rate for Payer: United Healthcare All Other HMO |
$303.86
|
| Rate for Payer: United Healthcare HMO Rider |
$297.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.42
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
OP
|
$831.82
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.36 |
| Max. Negotiated Rate |
$707.05 |
| Rate for Payer: Adventist Health Commercial |
$166.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$707.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$457.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$623.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$481.79
|
| Rate for Payer: Blue Shield of California Commercial |
$613.88
|
| Rate for Payer: Blue Shield of California EPN |
$404.26
|
| Rate for Payer: Cash Price |
$374.32
|
| Rate for Payer: Cigna of CA HMO |
$582.27
|
| Rate for Payer: Cigna of CA PPO |
$582.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$707.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$707.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$707.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.73
|
| Rate for Payer: EPIC Health Plan Senior |
$332.73
|
| Rate for Payer: Galaxy Health WC |
$707.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$554.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$514.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$582.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$582.27
|
| Rate for Payer: Multiplan Commercial |
$665.46
|
| Rate for Payer: Networks By Design Commercial |
$415.91
|
| Rate for Payer: Prime Health Services Commercial |
$707.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$499.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$499.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$312.18
|
| Rate for Payer: United Healthcare All Other HMO |
$303.86
|
| Rate for Payer: United Healthcare HMO Rider |
$297.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$272.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$707.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$707.05
|
| Rate for Payer: Vantage Medical Group Senior |
$707.05
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
IP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.66
|
| Rate for Payer: Multiplan Commercial |
$712.19
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
OP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$756.70 |
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$489.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$667.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$515.63
|
| Rate for Payer: Blue Shield of California Commercial |
$657.00
|
| Rate for Payer: Blue Shield of California EPN |
$432.66
|
| Rate for Payer: Cash Price |
$400.61
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$756.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$756.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.17
|
| Rate for Payer: Multiplan Commercial |
$712.19
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$534.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.70
|
| Rate for Payer: Vantage Medical Group Senior |
$756.70
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
IP
|
$910.62
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$182.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cigna of CA HMO |
$637.43
|
| Rate for Payer: Cigna of CA PPO |
$637.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$364.25
|
| Rate for Payer: EPIC Health Plan Senior |
$364.25
|
| Rate for Payer: Galaxy Health WC |
$774.03
|
| Rate for Payer: Global Benefits Group Commercial |
$546.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$607.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$563.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.55
|
| Rate for Payer: Multiplan Commercial |
$728.50
|
| Rate for Payer: Networks By Design Commercial |
$455.31
|
| Rate for Payer: Prime Health Services Commercial |
$774.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.76
|
| Rate for Payer: United Healthcare All Other HMO |
$332.65
|
| Rate for Payer: United Healthcare HMO Rider |
$325.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$298.23
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
OP
|
$910.62
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$774.03 |
| Rate for Payer: EPIC Health Plan Commercial |
$364.25
|
| Rate for Payer: EPIC Health Plan Senior |
$364.25
|
| Rate for Payer: Galaxy Health WC |
$774.03
|
| Rate for Payer: Global Benefits Group Commercial |
$546.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$607.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$563.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$637.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$637.43
|
| Rate for Payer: Multiplan Commercial |
$728.50
|
| Rate for Payer: Networks By Design Commercial |
$455.31
|
| Rate for Payer: Prime Health Services Commercial |
$774.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$546.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$546.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.76
|
| Rate for Payer: United Healthcare All Other HMO |
$332.65
|
| Rate for Payer: United Healthcare HMO Rider |
$325.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$298.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$774.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$774.03
|
| Rate for Payer: Vantage Medical Group Senior |
$774.03
|
| Rate for Payer: Adventist Health Commercial |
$182.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$774.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$500.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$682.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$527.43
|
| Rate for Payer: Blue Shield of California Commercial |
$672.04
|
| Rate for Payer: Blue Shield of California EPN |
$442.56
|
| Rate for Payer: Cash Price |
$409.78
|
| Rate for Payer: Cigna of CA HMO |
$637.43
|
| Rate for Payer: Cigna of CA PPO |
$637.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$774.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$774.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$774.03
|
|
