|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| 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 |
$1,412.43
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| 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 |
$1,495.00
|
| 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 |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| 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 MILLAR MICRO TIP SPC-320
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| 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 |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
IP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$990.16 |
| Rate for Payer: Adventist Health Commercial |
$232.98
|
| Rate for Payer: Cash Price |
$524.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: EPIC Health Plan Senior |
$465.96
|
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.58
|
| Rate for Payer: Multiplan Commercial |
$931.92
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
OP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$990.16 |
| Rate for Payer: Adventist Health Commercial |
$232.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$764.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$990.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$640.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$873.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$715.37
|
| Rate for Payer: Cash Price |
$524.20
|
| Rate for Payer: Cigna of CA HMO |
$745.54
|
| Rate for Payer: Cigna of CA PPO |
$862.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$990.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$990.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$990.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: EPIC Health Plan Senior |
$465.96
|
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$721.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.43
|
| Rate for Payer: Multiplan Commercial |
$931.92
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$698.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$698.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$582.45
|
| Rate for Payer: United Healthcare All Other HMO |
$582.45
|
| Rate for Payer: United Healthcare HMO Rider |
$582.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$582.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$990.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$990.16
|
| Rate for Payer: Vantage Medical Group Senior |
$990.16
|
|
|
HC CATH PEDIAVASC MONGOOSE
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.25
|
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.76
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.50
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.50
|
| Rate for Payer: United Healthcare All Other HMO |
$62.50
|
| Rate for Payer: United Healthcare HMO Rider |
$62.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: Vantage Medical Group Senior |
$106.25
|
|
|
HC CATH PEDIAVASC MONGOOSE
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$100.00
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
OP
|
$45.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$38.68 |
| Rate for Payer: Adventist Health Commercial |
$9.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.95
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cigna of CA HMO |
$29.13
|
| Rate for Payer: Cigna of CA PPO |
$33.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Senior |
$18.20
|
| Rate for Payer: Galaxy Health WC |
$38.68
|
| Rate for Payer: Global Benefits Group Commercial |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.86
|
| Rate for Payer: Multiplan Commercial |
$36.41
|
| Rate for Payer: Networks By Design Commercial |
$29.58
|
| Rate for Payer: Prime Health Services Commercial |
$38.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.75
|
| Rate for Payer: United Healthcare All Other HMO |
$22.75
|
| Rate for Payer: United Healthcare HMO Rider |
$22.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.68
|
| Rate for Payer: Vantage Medical Group Senior |
$38.68
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
IP
|
$45.51
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$38.68 |
| Rate for Payer: Adventist Health Commercial |
$9.10
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Senior |
$18.20
|
| Rate for Payer: Galaxy Health WC |
$38.68
|
| Rate for Payer: Global Benefits Group Commercial |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.92
|
| Rate for Payer: Multiplan Commercial |
$36.41
|
| Rate for Payer: Networks By Design Commercial |
$29.58
|
| Rate for Payer: Prime Health Services Commercial |
$38.68
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
IP
|
$49.28
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$41.89 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
OP
|
$49.28
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$41.89 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.26
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cigna of CA HMO |
$31.54
|
| Rate for Payer: Cigna of CA PPO |
$36.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.64
|
| Rate for Payer: United Healthcare All Other HMO |
$24.64
|
| Rate for Payer: United Healthcare HMO Rider |
$24.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.89
|
| Rate for Payer: Vantage Medical Group Senior |
$41.89
|
|
|
HC CATH PEDS FOLEY TRAY 10FR 5ML
|
Facility
|
IP
|
$226.45
|
|
| Hospital Charge Code |
901698909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$192.48 |
| Rate for Payer: Adventist Health Commercial |
$45.29
|
| Rate for Payer: Cash Price |
$101.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.58
|
| Rate for Payer: EPIC Health Plan Senior |
$90.58
|
| Rate for Payer: Galaxy Health WC |
$192.48
|
| Rate for Payer: Global Benefits Group Commercial |
$135.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$151.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.35
|
| Rate for Payer: Multiplan Commercial |
$181.16
|
| Rate for Payer: Networks By Design Commercial |
$147.19
|
| Rate for Payer: Prime Health Services Commercial |
$192.48
|
|
|
HC CATH PEDS FOLEY TRAY 10FR 5ML
|
Facility
|
OP
|
$226.45
|
|
| Hospital Charge Code |
901698909
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$192.48 |
| Rate for Payer: Adventist Health Commercial |
$45.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$192.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.06
|
| Rate for Payer: Cash Price |
$101.90
|
| Rate for Payer: Cigna of CA HMO |
$144.93
|
| Rate for Payer: Cigna of CA PPO |
$167.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$192.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$192.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$192.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.58
|
| Rate for Payer: EPIC Health Plan Senior |
$90.58
|
| Rate for Payer: Galaxy Health WC |
$192.48
|
| Rate for Payer: Global Benefits Group Commercial |
$135.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$151.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$158.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$158.51
|
| Rate for Payer: Multiplan Commercial |
$181.16
|
| Rate for Payer: Networks By Design Commercial |
$147.19
|
| Rate for Payer: Prime Health Services Commercial |
$192.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.22
|
| Rate for Payer: United Healthcare All Other HMO |
$113.22
|
| Rate for Payer: United Healthcare HMO Rider |
$113.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$192.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$192.48
|
| Rate for Payer: Vantage Medical Group Senior |
$192.48
|
|
|
HC CATH PEDS FOLEY TRAY 8FR 3ML
|
Facility
|
OP
|
$202.86
|
|
| Hospital Charge Code |
901698910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$172.43 |
| Rate for Payer: Adventist Health Commercial |
$40.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$172.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$111.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.58
|
| Rate for Payer: Cash Price |
$91.29
|
| Rate for Payer: Cigna of CA HMO |
$129.83
|
| Rate for Payer: Cigna of CA PPO |
$150.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$172.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$172.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$172.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.14
|
| Rate for Payer: EPIC Health Plan Senior |
$81.14
|
| Rate for Payer: Galaxy Health WC |
$172.43
|
| Rate for Payer: Global Benefits Group Commercial |
$121.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$125.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.00
|
| Rate for Payer: Multiplan Commercial |
$162.29
|
| Rate for Payer: Networks By Design Commercial |
$131.86
|
| Rate for Payer: Prime Health Services Commercial |
$172.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.43
|
| Rate for Payer: United Healthcare All Other HMO |
$101.43
|
| Rate for Payer: United Healthcare HMO Rider |
$101.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$172.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$172.43
|
| Rate for Payer: Vantage Medical Group Senior |
$172.43
|
|
|
HC CATH PEDS FOLEY TRAY 8FR 3ML
|
Facility
|
IP
|
$202.86
|
|
| Hospital Charge Code |
901698910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$172.43 |
| Rate for Payer: Adventist Health Commercial |
$40.57
|
| Rate for Payer: Cash Price |
$91.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.14
|
| Rate for Payer: EPIC Health Plan Senior |
$81.14
|
| Rate for Payer: Galaxy Health WC |
$172.43
|
| Rate for Payer: Global Benefits Group Commercial |
$121.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$125.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.69
|
| Rate for Payer: Multiplan Commercial |
$162.29
|
| Rate for Payer: Networks By Design Commercial |
$131.86
|
| Rate for Payer: Prime Health Services Commercial |
$172.43
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
OP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$14,582.60 |
| Rate for Payer: Adventist Health Commercial |
$3,431.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,435.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,867.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,936.76
|
| Rate for Payer: Blue Shield of California Commercial |
$12,661.13
|
| Rate for Payer: Blue Shield of California EPN |
$8,337.82
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,582.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,582.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,536.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,619.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,009.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,009.20
|
| Rate for Payer: Multiplan Commercial |
$13,724.80
|
| Rate for Payer: Networks By Design Commercial |
$8,578.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,293.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,293.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,438.65
|
| Rate for Payer: United Healthcare All Other HMO |
$6,267.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6,131.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,618.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,582.60
|
| Rate for Payer: Vantage Medical Group Senior |
$14,582.60
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
IP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$14,582.60 |
| Rate for Payer: Adventist Health Commercial |
$3,431.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,536.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,619.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,117.44
|
| Rate for Payer: Multiplan Commercial |
$13,724.80
|
| Rate for Payer: Networks By Design Commercial |
$8,578.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,438.65
|
| Rate for Payer: United Healthcare All Other HMO |
$6,267.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6,131.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,618.59
|
|
|
HC CATH PENUMBRA SELECT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
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 PENUMBRA SELECT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
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 PERITONEAL DIALYSIS PEDS
|
Facility
|
IP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Adventist Health Commercial |
$19.91
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: EPIC Health Plan Senior |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.89
|
| Rate for Payer: Multiplan Commercial |
$79.65
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
|
|
HC CATH PERITONEAL DIALYSIS PEDS
|
Facility
|
OP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Adventist Health Commercial |
$19.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.14
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$63.72
|
| Rate for Payer: Cigna of CA PPO |
$73.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: EPIC Health Plan Senior |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.69
|
| Rate for Payer: Multiplan Commercial |
$79.65
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.78
|
| Rate for Payer: United Healthcare All Other HMO |
$49.78
|
| Rate for Payer: United Healthcare HMO Rider |
$49.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.63
|
| Rate for Payer: Vantage Medical Group Senior |
$84.63
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,251.20 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$852.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.34
|
| Rate for Payer: Blue Shield of California EPN |
$715.39
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,030.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,030.40
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$319.14
|
| Rate for Payer: Blue Shield of California Commercial |
$406.64
|
| Rate for Payer: Blue Shield of California EPN |
$267.79
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
|
|
HC CATH PICC 5.5FR DL 55CM STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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
|
|
