|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.72
|
| Rate for Payer: Blue Shield of California Commercial |
$258.30
|
| Rate for Payer: Blue Shield of California EPN |
$170.10
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$663.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$621.47
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$708.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
OP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$558.20 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$430.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$361.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$492.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$403.28
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Cigna of CA HMO |
$420.29
|
| Rate for Payer: Cigna of CA PPO |
$485.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$558.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$558.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$406.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$459.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$459.69
|
| Rate for Payer: Multiplan Commercial |
$525.36
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.35
|
| Rate for Payer: United Healthcare All Other HMO |
$328.35
|
| Rate for Payer: United Healthcare HMO Rider |
$328.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.20
|
| Rate for Payer: Vantage Medical Group Senior |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
IP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$558.20 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$406.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.61
|
| Rate for Payer: Multiplan Commercial |
$525.36
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| 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 |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| 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 |
$356.18
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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 PIGTAIL 5.5F 70CM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.36
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Cigna of CA HMO |
$72.28
|
| Rate for Payer: Cigna of CA PPO |
$83.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.47
|
| Rate for Payer: United Healthcare All Other HMO |
$56.47
|
| Rate for Payer: United Healthcare HMO Rider |
$56.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
OP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$96.97 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.06
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.86
|
| Rate for Payer: Multiplan Commercial |
$91.26
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
IP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$96.97 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Multiplan Commercial |
$91.26
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC CATH PIV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$232.05
|
|
| Hospital Charge Code |
901698174
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$197.24 |
| Rate for Payer: Adventist Health Commercial |
$46.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$197.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.50
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cigna of CA HMO |
$148.51
|
| Rate for Payer: Cigna of CA PPO |
$171.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$197.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$197.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$197.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.82
|
| Rate for Payer: EPIC Health Plan Senior |
$92.82
|
| Rate for Payer: Galaxy Health WC |
$197.24
|
| Rate for Payer: Global Benefits Group Commercial |
$139.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$162.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$185.64
|
| Rate for Payer: Networks By Design Commercial |
$150.83
|
| Rate for Payer: Prime Health Services Commercial |
$197.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.03
|
| Rate for Payer: United Healthcare All Other HMO |
$116.03
|
| Rate for Payer: United Healthcare HMO Rider |
$116.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$197.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$197.24
|
| Rate for Payer: Vantage Medical Group Senior |
$197.24
|
|
|
HC CATH PIV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$232.05
|
|
| Hospital Charge Code |
901698174
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$197.24 |
| Rate for Payer: Adventist Health Commercial |
$46.41
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.82
|
| Rate for Payer: EPIC Health Plan Senior |
$92.82
|
| Rate for Payer: Galaxy Health WC |
$197.24
|
| Rate for Payer: Global Benefits Group Commercial |
$139.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.69
|
| Rate for Payer: Multiplan Commercial |
$185.64
|
| Rate for Payer: Networks By Design Commercial |
$150.83
|
| Rate for Payer: Prime Health Services Commercial |
$197.24
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
OP
|
$609.50
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$518.08 |
| Rate for Payer: Adventist Health Commercial |
$121.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$518.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$353.02
|
| Rate for Payer: Blue Shield of California Commercial |
$449.81
|
| Rate for Payer: Blue Shield of California EPN |
$296.22
|
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Cigna of CA HMO |
$426.65
|
| Rate for Payer: Cigna of CA PPO |
$426.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$518.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$518.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$518.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.80
|
| Rate for Payer: EPIC Health Plan Senior |
$243.80
|
| Rate for Payer: Galaxy Health WC |
$518.08
|
| Rate for Payer: Global Benefits Group Commercial |
$365.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$406.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$377.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$426.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$426.65
|
| Rate for Payer: Multiplan Commercial |
$487.60
|
| Rate for Payer: Networks By Design Commercial |
$304.75
|
| Rate for Payer: Prime Health Services Commercial |
$518.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$365.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$365.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.75
|
| Rate for Payer: United Healthcare All Other HMO |
$222.65
|
| Rate for Payer: United Healthcare HMO Rider |
$217.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$518.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$518.08
|
| Rate for Payer: Vantage Medical Group Senior |
$518.08
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
IP
|
$609.50
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$121.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Cigna of CA HMO |
$426.65
|
| Rate for Payer: Cigna of CA PPO |
$426.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.80
|
| Rate for Payer: EPIC Health Plan Senior |
$243.80
|
| Rate for Payer: Galaxy Health WC |
$518.08
|
| Rate for Payer: Global Benefits Group Commercial |
$365.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$406.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$377.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Multiplan Commercial |
$487.60
|
| Rate for Payer: Networks By Design Commercial |
$304.75
|
| Rate for Payer: Prime Health Services Commercial |
$518.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.75
|
| Rate for Payer: United Healthcare All Other HMO |
$222.65
|
| Rate for Payer: United Healthcare HMO Rider |
$217.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.61
|
|
|
HC CATH PMO LICOX
|
Facility
|
OP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,209.72 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,476.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,076.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,832.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,318.93
|
| Rate for Payer: Cash Price |
$1,699.26
|
| Rate for Payer: Cigna of CA HMO |
$2,416.73
|
| Rate for Payer: Cigna of CA PPO |
$2,794.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,209.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,209.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,518.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,438.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,337.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$906.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,643.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,643.30
|
| Rate for Payer: Multiplan Commercial |
$3,020.91
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,265.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,265.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,888.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1,888.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1,888.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,888.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Senior |
$3,209.72
|
|
|
HC CATH PMO LICOX
|
Facility
|
IP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,209.72 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Cash Price |
$1,699.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,518.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,438.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,337.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$906.27
|
| Rate for Payer: Multiplan Commercial |
$3,020.91
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.12
|
| Rate for Payer: Multiplan Commercial |
$190.40
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$156.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$178.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.16
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$202.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$166.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$190.40
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,251.20 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$852.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.34
|
| Rate for Payer: Blue Shield of California EPN |
$715.39
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,030.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,030.40
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
OP
|
$2,087.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.57 |
| Max. Negotiated Rate |
$1,774.67 |
| Rate for Payer: Adventist Health Commercial |
$417.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,774.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,148.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,209.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,540.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,014.70
|
| Rate for Payer: Cash Price |
$939.53
|
| Rate for Payer: Cigna of CA HMO |
$1,461.49
|
| Rate for Payer: Cigna of CA PPO |
$1,461.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,774.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,774.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,774.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$835.14
|
| Rate for Payer: EPIC Health Plan Senior |
$835.14
|
| Rate for Payer: Galaxy Health WC |
$1,774.67
|
| Rate for Payer: Global Benefits Group Commercial |
$1,252.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,392.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$795.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,292.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,461.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,461.49
|
| Rate for Payer: Multiplan Commercial |
$1,670.28
|
| Rate for Payer: Networks By Design Commercial |
$1,043.92
|
| Rate for Payer: Prime Health Services Commercial |
$1,774.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,252.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,252.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.57
|
| Rate for Payer: United Healthcare All Other HMO |
$762.69
|
| Rate for Payer: United Healthcare HMO Rider |
$746.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,774.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,774.67
|
| Rate for Payer: Vantage Medical Group Senior |
$1,774.67
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
IP
|
$2,087.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.57 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$417.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$939.53
|
| Rate for Payer: Cash Price |
$939.53
|
| Rate for Payer: Cigna of CA HMO |
$1,461.49
|
| Rate for Payer: Cigna of CA PPO |
$1,461.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$835.14
|
| Rate for Payer: EPIC Health Plan Senior |
$835.14
|
| Rate for Payer: Galaxy Health WC |
$1,774.67
|
| Rate for Payer: Global Benefits Group Commercial |
$1,252.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,392.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$795.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,292.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.08
|
| Rate for Payer: Multiplan Commercial |
$1,670.28
|
| Rate for Payer: Networks By Design Commercial |
$1,043.92
|
| Rate for Payer: Prime Health Services Commercial |
$1,774.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.57
|
| Rate for Payer: United Healthcare All Other HMO |
$762.69
|
| Rate for Payer: United Healthcare HMO Rider |
$746.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.77
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
IP
|
$1,276.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.34 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$255.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$574.51
|
| Rate for Payer: Cash Price |
$574.51
|
| Rate for Payer: Cigna of CA HMO |
$893.68
|
| Rate for Payer: Cigna of CA PPO |
$893.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.67
|
| Rate for Payer: EPIC Health Plan Senior |
$510.67
|
| Rate for Payer: Galaxy Health WC |
$1,085.18
|
| Rate for Payer: Global Benefits Group Commercial |
$766.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$851.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$790.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$306.40
|
| Rate for Payer: Multiplan Commercial |
$1,021.34
|
| Rate for Payer: Networks By Design Commercial |
$638.34
|
| Rate for Payer: Prime Health Services Commercial |
$1,085.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.14
|
| Rate for Payer: United Healthcare All Other HMO |
$466.37
|
| Rate for Payer: United Healthcare HMO Rider |
$456.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.11
|
|
