|
HC CATH PICC 5.5FR DL 55CM STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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 PICC 5FR DL 55CM W/STYLET
|
Facility
|
IP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$813.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,321.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.26
|
| Rate for Payer: Multiplan Commercial |
$1,707.52
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
|
|
HC CATH PICC 5FR DL 55CM W/STYLET
|
Facility
|
OP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$1,814.24 |
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,173.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,600.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,236.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,575.19
|
| Rate for Payer: Blue Shield of California EPN |
$1,037.32
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,814.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,814.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$813.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,321.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,494.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,494.08
|
| Rate for Payer: Multiplan Commercial |
$1,707.52
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,280.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,280.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,814.24
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,111.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$634.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,031.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.89
|
| Rate for Payer: Multiplan Commercial |
$1,332.97
|
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$1,416.28 |
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$916.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,249.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$965.07
|
| Rate for Payer: Blue Shield of California Commercial |
$1,229.66
|
| Rate for Payer: Blue Shield of California EPN |
$809.78
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,416.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,416.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,111.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$634.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,031.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,166.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,166.35
|
| Rate for Payer: Multiplan Commercial |
$1,332.97
|
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$999.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$999.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Senior |
$1,416.28
|
|
|
HC CATH PICC DUAL LUMEN 1.9FR
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC INS TRAY NEONATAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$229.56
|
| 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 |
$214.94
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| 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 |
$227.50
|
| 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 |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| 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 PICC INS TRAY NEONATAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| 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: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
OP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$804.68 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$520.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$710.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$548.32
|
| Rate for Payer: Blue Shield of California Commercial |
$698.65
|
| Rate for Payer: Blue Shield of California EPN |
$460.09
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$804.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$804.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$804.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$631.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$585.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$662.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$662.68
|
| Rate for Payer: Multiplan Commercial |
$757.34
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$568.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$568.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$804.68
|
| Rate for Payer: Vantage Medical Group Senior |
$804.68
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
IP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$631.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$585.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.20
|
| Rate for Payer: Multiplan Commercial |
$757.34
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
IP
|
$1,615.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cigna of CA HMO |
$1,130.51
|
| Rate for Payer: Cigna of CA PPO |
$1,130.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.76
|
| Rate for Payer: Global Benefits Group Commercial |
$969.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,077.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$615.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$999.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.60
|
| Rate for Payer: Multiplan Commercial |
$1,292.01
|
| Rate for Payer: Networks By Design Commercial |
$807.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.11
|
| Rate for Payer: United Healthcare All Other HMO |
$589.96
|
| Rate for Payer: United Healthcare HMO Rider |
$577.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.92
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
OP
|
$1,615.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$1,372.76 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$888.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,211.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$935.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,191.88
|
| Rate for Payer: Blue Shield of California EPN |
$784.89
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cigna of CA HMO |
$1,130.51
|
| Rate for Payer: Cigna of CA PPO |
$1,130.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,372.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,372.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.76
|
| Rate for Payer: Global Benefits Group Commercial |
$969.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,077.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$615.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$999.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,130.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,130.51
|
| Rate for Payer: Multiplan Commercial |
$1,292.01
|
| Rate for Payer: Networks By Design Commercial |
$807.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$969.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$969.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.11
|
| Rate for Payer: United Healthcare All Other HMO |
$589.96
|
| Rate for Payer: United Healthcare HMO Rider |
$577.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,372.76
|
| Rate for Payer: Vantage Medical Group Senior |
$1,372.76
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
IP
|
$387.03
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.41 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$77.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cigna of CA HMO |
$270.92
|
| Rate for Payer: Cigna of CA PPO |
$270.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.81
|
| Rate for Payer: EPIC Health Plan Senior |
$154.81
|
| Rate for Payer: Galaxy Health WC |
$328.98
|
| Rate for Payer: Global Benefits Group Commercial |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$258.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.89
|
| Rate for Payer: Multiplan Commercial |
$309.62
|
| Rate for Payer: Networks By Design Commercial |
$193.51
|
| Rate for Payer: Prime Health Services Commercial |
$328.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.25
|
| Rate for Payer: United Healthcare All Other HMO |
$141.38
|
| Rate for Payer: United Healthcare HMO Rider |
$138.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.75
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
OP
|
$387.03
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.41 |
| Max. Negotiated Rate |
$328.98 |
| Rate for Payer: Adventist Health Commercial |
$77.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$290.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.17
|
| Rate for Payer: Blue Shield of California Commercial |
$285.63
|
| Rate for Payer: Blue Shield of California EPN |
$188.10
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cigna of CA HMO |
$270.92
|
| Rate for Payer: Cigna of CA PPO |
$270.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.81
|
| Rate for Payer: EPIC Health Plan Senior |
$154.81
|
| Rate for Payer: Galaxy Health WC |
$328.98
|
| Rate for Payer: Global Benefits Group Commercial |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$258.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.92
|
| Rate for Payer: Multiplan Commercial |
$309.62
|
| Rate for Payer: Networks By Design Commercial |
$193.51
|
| Rate for Payer: Prime Health Services Commercial |
$328.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$232.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$232.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.25
|
| Rate for Payer: United Healthcare All Other HMO |
$141.38
|
| Rate for Payer: United Healthcare HMO Rider |
$138.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.98
|
| Rate for Payer: Vantage Medical Group Senior |
$328.98
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
IP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$223.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.78
|
| Rate for Payer: Multiplan Commercial |
$289.26
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
OP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$307.33 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$271.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$209.42
|
| Rate for Payer: Blue Shield of California Commercial |
$266.84
|
| Rate for Payer: Blue Shield of California EPN |
$175.72
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$307.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$307.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$223.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$253.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$253.10
|
| Rate for Payer: Multiplan Commercial |
$289.26
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$216.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$216.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$307.33
|
| Rate for Payer: Vantage Medical Group Senior |
$307.33
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
OP
|
$386.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.28 |
| Max. Negotiated Rate |
$328.44 |
| Rate for Payer: Adventist Health Commercial |
$77.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$289.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.80
|
| Rate for Payer: Blue Shield of California Commercial |
$285.16
|
| Rate for Payer: Blue Shield of California EPN |
$187.79
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cigna of CA HMO |
$270.48
|
| Rate for Payer: Cigna of CA PPO |
$270.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.56
|
| Rate for Payer: EPIC Health Plan Senior |
$154.56
|
| Rate for Payer: Galaxy Health WC |
$328.44
|
| Rate for Payer: Global Benefits Group Commercial |
$231.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$257.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.48
|
| Rate for Payer: Multiplan Commercial |
$309.12
|
| Rate for Payer: Networks By Design Commercial |
$193.20
|
| Rate for Payer: Prime Health Services Commercial |
$328.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.02
|
| Rate for Payer: United Healthcare All Other HMO |
$141.15
|
| Rate for Payer: United Healthcare HMO Rider |
$138.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.44
|
| Rate for Payer: Vantage Medical Group Senior |
$328.44
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
IP
|
$386.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.28 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$77.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cigna of CA HMO |
$270.48
|
| Rate for Payer: Cigna of CA PPO |
$270.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.56
|
| Rate for Payer: EPIC Health Plan Senior |
$154.56
|
| Rate for Payer: Galaxy Health WC |
$328.44
|
| Rate for Payer: Global Benefits Group Commercial |
$231.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$257.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.74
|
| Rate for Payer: Multiplan Commercial |
$309.12
|
| Rate for Payer: Networks By Design Commercial |
$193.20
|
| Rate for Payer: Prime Health Services Commercial |
$328.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.02
|
| Rate for Payer: United Healthcare All Other HMO |
$141.15
|
| Rate for Payer: United Healthcare HMO Rider |
$138.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.55
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$993.14 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$642.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$876.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$676.74
|
| Rate for Payer: Blue Shield of California Commercial |
$862.28
|
| Rate for Payer: Blue Shield of California EPN |
$567.84
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$993.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$993.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$993.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$723.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$817.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$817.88
|
| Rate for Payer: Multiplan Commercial |
$934.72
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$701.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$701.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$993.14
|
| Rate for Payer: Vantage Medical Group Senior |
$993.14
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$723.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.42
|
| Rate for Payer: Multiplan Commercial |
$934.72
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
OP
|
$1,098.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.68 |
| Max. Negotiated Rate |
$933.63 |
| Rate for Payer: Adventist Health Commercial |
$219.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$933.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$604.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$823.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$636.19
|
| Rate for Payer: Blue Shield of California Commercial |
$810.61
|
| Rate for Payer: Blue Shield of California EPN |
$533.82
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cigna of CA HMO |
$768.87
|
| Rate for Payer: Cigna of CA PPO |
$768.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$933.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$933.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$933.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.36
|
| Rate for Payer: EPIC Health Plan Senior |
$439.36
|
| Rate for Payer: Galaxy Health WC |
$933.63
|
| Rate for Payer: Global Benefits Group Commercial |
$659.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$418.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$679.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$768.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$768.87
|
| Rate for Payer: Multiplan Commercial |
$878.71
|
| Rate for Payer: Networks By Design Commercial |
$549.20
|
| Rate for Payer: Prime Health Services Commercial |
$933.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$659.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$659.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$412.23
|
| Rate for Payer: United Healthcare All Other HMO |
$401.24
|
| Rate for Payer: United Healthcare HMO Rider |
$392.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$359.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$933.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$933.63
|
| Rate for Payer: Vantage Medical Group Senior |
$933.63
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
IP
|
$1,098.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.68 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$219.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cigna of CA HMO |
$768.87
|
| Rate for Payer: Cigna of CA PPO |
$768.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.36
|
| Rate for Payer: EPIC Health Plan Senior |
$439.36
|
| Rate for Payer: Galaxy Health WC |
$933.63
|
| Rate for Payer: Global Benefits Group Commercial |
$659.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$732.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$418.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$679.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.61
|
| Rate for Payer: Multiplan Commercial |
$878.71
|
| Rate for Payer: Networks By Design Commercial |
$549.20
|
| Rate for Payer: Prime Health Services Commercial |
$933.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$412.23
|
| Rate for Payer: United Healthcare All Other HMO |
$401.24
|
| Rate for Payer: United Healthcare HMO Rider |
$392.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$359.72
|
|
