|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
IP
|
$2,086.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.28 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$417.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cigna of CA HMO |
$1,460.49
|
| Rate for Payer: Cigna of CA PPO |
$1,460.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.57
|
| Rate for Payer: EPIC Health Plan Senior |
$834.57
|
| Rate for Payer: Galaxy Health WC |
$1,773.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,391.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$794.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,291.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.74
|
| Rate for Payer: Multiplan Commercial |
$1,669.14
|
| Rate for Payer: Networks By Design Commercial |
$1,043.21
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.03
|
| Rate for Payer: United Healthcare All Other HMO |
$762.17
|
| Rate for Payer: United Healthcare HMO Rider |
$745.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.30
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
OP
|
$2,086.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.28 |
| Max. Negotiated Rate |
$1,773.46 |
| Rate for Payer: Adventist Health Commercial |
$417.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,147.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,564.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,208.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,539.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,014.00
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cigna of CA HMO |
$1,460.49
|
| Rate for Payer: Cigna of CA PPO |
$1,460.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,773.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,773.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.57
|
| Rate for Payer: EPIC Health Plan Senior |
$834.57
|
| Rate for Payer: Galaxy Health WC |
$1,773.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,391.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$794.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,291.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,460.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,460.49
|
| Rate for Payer: Multiplan Commercial |
$1,669.14
|
| Rate for Payer: Networks By Design Commercial |
$1,043.21
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,251.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,251.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.03
|
| Rate for Payer: United Healthcare All Other HMO |
$762.17
|
| Rate for Payer: United Healthcare HMO Rider |
$745.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,773.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1,773.46
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$543.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$741.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$572.83
|
| Rate for Payer: Blue Shield of California Commercial |
$729.88
|
| Rate for Payer: Blue Shield of California EPN |
$480.65
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$840.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$840.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$840.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$692.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$692.30
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$840.65
|
| Rate for Payer: Vantage Medical Group Senior |
$840.65
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,090.89 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$962.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$743.35
|
| Rate for Payer: Blue Shield of California Commercial |
$947.15
|
| Rate for Payer: Blue Shield of California EPN |
$623.73
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,090.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$898.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$898.38
|
| Rate for Payer: Multiplan Commercial |
$1,026.72
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.02
|
| Rate for Payer: Multiplan Commercial |
$1,026.72
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
IP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$897.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$833.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.11
|
| Rate for Payer: Multiplan Commercial |
$1,077.02
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
OP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$1,144.34 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$740.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,009.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$779.77
|
| Rate for Payer: Blue Shield of California Commercial |
$993.55
|
| Rate for Payer: Blue Shield of California EPN |
$654.29
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,144.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,144.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$897.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$833.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$942.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$942.40
|
| Rate for Payer: Multiplan Commercial |
$1,077.02
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$807.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$807.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,144.34
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,051.79 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$716.70
|
| Rate for Payer: Blue Shield of California Commercial |
$913.20
|
| Rate for Payer: Blue Shield of California EPN |
$601.38
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,051.79 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$716.70
|
| Rate for Payer: Blue Shield of California Commercial |
$913.20
|
| Rate for Payer: Blue Shield of California EPN |
$601.38
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
IP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,062.19 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Cash Price |
$562.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.91
|
| Rate for Payer: Multiplan Commercial |
$999.71
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
OP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,062.19 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$819.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$687.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$937.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$767.40
|
| Rate for Payer: Cash Price |
$562.34
|
| Rate for Payer: Cigna of CA HMO |
$799.77
|
| Rate for Payer: Cigna of CA PPO |
$924.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,062.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$874.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$874.75
|
| Rate for Payer: Multiplan Commercial |
$999.71
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.82
|
| Rate for Payer: United Healthcare All Other HMO |
$624.82
|
| Rate for Payer: United Healthcare HMO Rider |
$624.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
IP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,104.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,024.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.33
|
| Rate for Payer: Multiplan Commercial |
$1,324.43
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
OP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$1,407.21 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$910.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,241.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$958.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,221.79
|
| Rate for Payer: Blue Shield of California EPN |
$804.59
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,407.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,407.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,104.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,024.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,158.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,158.88
|
| Rate for Payer: Multiplan Commercial |
$1,324.43
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$993.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$993.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Senior |
$1,407.21
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
OP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$779.07 |
| Rate for Payer: Adventist Health Commercial |
$183.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$504.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.87
|
| Rate for Payer: Blue Shield of California Commercial |
$676.41
|
| Rate for Payer: Blue Shield of California EPN |
$445.44
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Cigna of CA HMO |
$641.59
|
| Rate for Payer: Cigna of CA PPO |
$641.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$779.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$779.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$779.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Senior |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$567.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$641.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$641.59
|
| Rate for Payer: Multiplan Commercial |
$733.24
|
| Rate for Payer: Networks By Design Commercial |
$458.27
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$549.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$549.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.98
|
| Rate for Payer: United Healthcare All Other HMO |
$334.82
|
| Rate for Payer: United Healthcare HMO Rider |
$327.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$779.07
|
| Rate for Payer: Vantage Medical Group Senior |
$779.07
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
IP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$183.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Cigna of CA HMO |
$641.59
|
| Rate for Payer: Cigna of CA PPO |
$641.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Senior |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$567.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.97
|
| Rate for Payer: Multiplan Commercial |
$733.24
|
| Rate for Payer: Networks By Design Commercial |
$458.27
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.98
|
| Rate for Payer: United Healthcare All Other HMO |
$334.82
|
| Rate for Payer: United Healthcare HMO Rider |
$327.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.17
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
IP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$188.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$423.32
|
| Rate for Payer: Cash Price |
$423.32
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Senior |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.77
|
| Rate for Payer: Multiplan Commercial |
$752.56
|
| Rate for Payer: Networks By Design Commercial |
$470.35
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.04
|
| Rate for Payer: United Healthcare All Other HMO |
$343.64
|
| Rate for Payer: United Healthcare HMO Rider |
$336.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.08
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
OP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$799.60 |
| Rate for Payer: Adventist Health Commercial |
$188.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.85
|
| Rate for Payer: Blue Shield of California Commercial |
$694.24
|
| Rate for Payer: Blue Shield of California EPN |
$457.18
|
| Rate for Payer: Cash Price |
$423.32
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Senior |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.49
|
| Rate for Payer: Multiplan Commercial |
$752.56
|
| Rate for Payer: Networks By Design Commercial |
$470.35
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.04
|
| Rate for Payer: United Healthcare All Other HMO |
$343.64
|
| Rate for Payer: United Healthcare HMO Rider |
$336.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.60
|
| Rate for Payer: Vantage Medical Group Senior |
$799.60
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
IP
|
$1,608.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.71 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$321.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$723.84
|
| Rate for Payer: Cash Price |
$723.84
|
| Rate for Payer: Cigna of CA HMO |
$1,125.97
|
| Rate for Payer: Cigna of CA PPO |
$1,125.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.41
|
| Rate for Payer: EPIC Health Plan Senior |
$643.41
|
| Rate for Payer: Galaxy Health WC |
$1,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$965.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$995.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.05
|
| Rate for Payer: Multiplan Commercial |
$1,286.82
|
| Rate for Payer: Networks By Design Commercial |
$804.26
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$603.68
|
| Rate for Payer: United Healthcare All Other HMO |
$587.60
|
| Rate for Payer: United Healthcare HMO Rider |
$574.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$526.79
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
OP
|
$1,608.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.71 |
| Max. Negotiated Rate |
$1,367.25 |
| Rate for Payer: Adventist Health Commercial |
$321.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,367.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$884.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,206.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$931.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,187.10
|
| Rate for Payer: Blue Shield of California EPN |
$781.75
|
| Rate for Payer: Cash Price |
$723.84
|
| Rate for Payer: Cigna of CA HMO |
$1,125.97
|
| Rate for Payer: Cigna of CA PPO |
$1,125.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,367.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,367.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,367.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.41
|
| Rate for Payer: EPIC Health Plan Senior |
$643.41
|
| Rate for Payer: Galaxy Health WC |
$1,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$965.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$995.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,125.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,125.97
|
| Rate for Payer: Multiplan Commercial |
$1,286.82
|
| Rate for Payer: Networks By Design Commercial |
$804.26
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$965.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$965.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$603.68
|
| Rate for Payer: United Healthcare All Other HMO |
$587.60
|
| Rate for Payer: United Healthcare HMO Rider |
$574.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$526.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,367.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,367.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,367.25
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
OP
|
$1,410.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.07 |
| Max. Negotiated Rate |
$1,198.81 |
| Rate for Payer: Adventist Health Commercial |
$282.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,198.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$775.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,057.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$816.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,040.85
|
| Rate for Payer: Blue Shield of California EPN |
$685.43
|
| Rate for Payer: Cash Price |
$634.66
|
| Rate for Payer: Cigna of CA HMO |
$987.25
|
| Rate for Payer: Cigna of CA PPO |
$987.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,198.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,198.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,198.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$564.14
|
| Rate for Payer: EPIC Health Plan Senior |
$564.14
|
| Rate for Payer: Galaxy Health WC |
$1,198.81
|
| Rate for Payer: Global Benefits Group Commercial |
$846.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$940.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$537.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$873.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$987.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$987.25
|
| Rate for Payer: Multiplan Commercial |
$1,128.29
|
| Rate for Payer: Networks By Design Commercial |
$705.18
|
| Rate for Payer: Prime Health Services Commercial |
$1,198.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$846.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$846.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$529.31
|
| Rate for Payer: United Healthcare All Other HMO |
$515.20
|
| Rate for Payer: United Healthcare HMO Rider |
$504.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$461.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,198.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,198.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,198.81
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
IP
|
$1,410.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.07 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$282.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$634.66
|
| Rate for Payer: Cash Price |
$634.66
|
| Rate for Payer: Cigna of CA HMO |
$987.25
|
| Rate for Payer: Cigna of CA PPO |
$987.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$564.14
|
| Rate for Payer: EPIC Health Plan Senior |
$564.14
|
| Rate for Payer: Galaxy Health WC |
$1,198.81
|
| Rate for Payer: Global Benefits Group Commercial |
$846.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$940.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$537.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$873.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.49
|
| Rate for Payer: Multiplan Commercial |
$1,128.29
|
| Rate for Payer: Networks By Design Commercial |
$705.18
|
| Rate for Payer: Prime Health Services Commercial |
$1,198.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$529.31
|
| Rate for Payer: United Healthcare All Other HMO |
$515.20
|
| Rate for Payer: United Healthcare HMO Rider |
$504.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$461.89
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
OP
|
$1,405.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.17 |
| Max. Negotiated Rate |
$1,194.97 |
| Rate for Payer: Adventist Health Commercial |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,194.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,054.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$814.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1,037.52
|
| Rate for Payer: Blue Shield of California EPN |
$683.24
|
| Rate for Payer: Cash Price |
$632.63
|
| Rate for Payer: Cigna of CA HMO |
$984.10
|
| Rate for Payer: Cigna of CA PPO |
$984.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,194.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,194.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,194.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.34
|
| Rate for Payer: EPIC Health Plan Senior |
$562.34
|
| Rate for Payer: Galaxy Health WC |
$1,194.97
|
| Rate for Payer: Global Benefits Group Commercial |
$843.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$937.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$870.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$337.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$984.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$984.10
|
| Rate for Payer: Multiplan Commercial |
$1,124.68
|
| Rate for Payer: Networks By Design Commercial |
$702.92
|
| Rate for Payer: Prime Health Services Commercial |
$1,194.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$843.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$843.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$527.62
|
| Rate for Payer: United Healthcare All Other HMO |
$513.56
|
| Rate for Payer: United Healthcare HMO Rider |
$502.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$460.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,194.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,194.97
|
| Rate for Payer: Vantage Medical Group Senior |
$1,194.97
|
|
