|
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
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
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, PREMICATH 1FR 28G,20CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
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 PRIMO MALE 16" 12FR COUDE
|
Facility
|
OP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.60
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$17.71
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
IP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.31
|
| Rate for Payer: Multiplan Commercial |
$17.71
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$20.14 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.69
|
| Rate for Payer: Multiplan Commercial |
$18.96
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$20.14 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.55
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cigna of CA HMO |
$15.17
|
| Rate for Payer: Cigna of CA PPO |
$17.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.59
|
| Rate for Payer: Multiplan Commercial |
$18.96
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO |
$11.85
|
| Rate for Payer: United Healthcare HMO Rider |
$11.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.14
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
OP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,622.30 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,566.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,990.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,078.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,339.48
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Cigna of CA HMO |
$3,480.32
|
| Rate for Payer: Cigna of CA PPO |
$4,024.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,622.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,366.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,806.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,806.60
|
| Rate for Payer: Multiplan Commercial |
$4,350.40
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,262.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,262.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,719.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Senior |
$4,622.30
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
IP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,622.30 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,366.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.12
|
| Rate for Payer: Multiplan Commercial |
$4,350.40
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
IP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$105.82 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Cash Price |
$56.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.88
|
| Rate for Payer: Multiplan Commercial |
$99.59
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
OP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$105.82 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.45
|
| Rate for Payer: Cash Price |
$56.02
|
| Rate for Payer: Cigna of CA HMO |
$79.67
|
| Rate for Payer: Cigna of CA PPO |
$92.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.14
|
| Rate for Payer: Multiplan Commercial |
$99.59
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.24
|
| Rate for Payer: United Healthcare All Other HMO |
$62.24
|
| Rate for Payer: United Healthcare HMO Rider |
$62.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.82
|
| Rate for Payer: Vantage Medical Group Senior |
$105.82
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
IP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$55.28 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Multiplan Commercial |
$52.02
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
OP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$55.28 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.93
|
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: Cigna of CA HMO |
$41.62
|
| Rate for Payer: Cigna of CA PPO |
$48.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.52
|
| Rate for Payer: Multiplan Commercial |
$52.02
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.52
|
| Rate for Payer: United Healthcare All Other HMO |
$32.52
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.28
|
| Rate for Payer: Vantage Medical Group Senior |
$55.28
|
|
|
HC CATH PWR PICC 4.5FR 45CM
|
Facility
|
OP
|
$1,367.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.47 |
| Max. Negotiated Rate |
$1,162.25 |
| Rate for Payer: Adventist Health Commercial |
$273.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,025.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$791.97
|
| Rate for Payer: Blue Shield of California Commercial |
$1,009.10
|
| Rate for Payer: Blue Shield of California EPN |
$664.53
|
| Rate for Payer: Cash Price |
$615.31
|
| Rate for Payer: Cigna of CA HMO |
$957.14
|
| Rate for Payer: Cigna of CA PPO |
$957.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,162.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,162.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.94
|
| Rate for Payer: EPIC Health Plan Senior |
$546.94
|
| Rate for Payer: Galaxy Health WC |
$1,162.25
|
| Rate for Payer: Global Benefits Group Commercial |
$820.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$912.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$957.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$957.14
|
| Rate for Payer: Multiplan Commercial |
$1,093.88
|
| Rate for Payer: Networks By Design Commercial |
$683.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,162.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$820.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$820.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$513.17
|
| Rate for Payer: United Healthcare All Other HMO |
$499.49
|
| Rate for Payer: United Healthcare HMO Rider |
$488.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$447.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,162.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,162.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,162.25
|
|
|
HC CATH PWR PICC 4.5FR 45CM
|
Facility
|
IP
|
$1,367.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.47 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$273.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$615.31
|
| Rate for Payer: Cash Price |
$615.31
|
| Rate for Payer: Cigna of CA HMO |
$957.14
|
| Rate for Payer: Cigna of CA PPO |
$957.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.94
|
| Rate for Payer: EPIC Health Plan Senior |
$546.94
|
| Rate for Payer: Galaxy Health WC |
$1,162.25
|
| Rate for Payer: Global Benefits Group Commercial |
$820.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$912.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.16
|
| Rate for Payer: Multiplan Commercial |
$1,093.88
|
| Rate for Payer: Networks By Design Commercial |
$683.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,162.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$513.17
|
| Rate for Payer: United Healthcare All Other HMO |
$499.49
|
| Rate for Payer: United Healthcare HMO Rider |
$488.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$447.81
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
OP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,120.53 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$725.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$988.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$763.54
|
| Rate for Payer: Blue Shield of California Commercial |
$972.88
|
| Rate for Payer: Blue Shield of California EPN |
$640.68
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,120.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,120.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$816.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$316.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$922.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$922.79
|
| Rate for Payer: Multiplan Commercial |
$1,054.62
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$790.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$790.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,120.53
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
IP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$879.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$816.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$316.38
|
| Rate for Payer: Multiplan Commercial |
$1,054.62
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
IP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.77
|
| Rate for Payer: Multiplan Commercial |
$385.91
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
OP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$410.03 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$279.40
|
| Rate for Payer: Blue Shield of California Commercial |
$356.00
|
| Rate for Payer: Blue Shield of California EPN |
$234.44
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$337.67
|
| Rate for Payer: Multiplan Commercial |
$385.91
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.03
|
| Rate for Payer: Vantage Medical Group Senior |
$410.03
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.36
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$184.87 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$173.99
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$184.87 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.56
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Cigna of CA HMO |
$139.19
|
| Rate for Payer: Cigna of CA PPO |
$160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.24
|
| Rate for Payer: Multiplan Commercial |
$173.99
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.75
|
| Rate for Payer: United Healthcare All Other HMO |
$108.75
|
| Rate for Payer: United Healthcare HMO Rider |
$108.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.87
|
| Rate for Payer: Vantage Medical Group Senior |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
IP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$316.12 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Cash Price |
$167.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.26
|
| Rate for Payer: Multiplan Commercial |
$297.52
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
|
|
HC CATH RADL ARTERY TRAY 3FR 1LUM
|
Facility
|
OP
|
$371.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698679
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$316.12 |
| Rate for Payer: Adventist Health Commercial |
$74.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$204.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$278.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.38
|
| Rate for Payer: Cash Price |
$167.35
|
| Rate for Payer: Cigna of CA HMO |
$238.02
|
| Rate for Payer: Cigna of CA PPO |
$275.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$316.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$316.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$316.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.76
|
| Rate for Payer: EPIC Health Plan Senior |
$148.76
|
| Rate for Payer: Galaxy Health WC |
$316.12
|
| Rate for Payer: Global Benefits Group Commercial |
$223.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$260.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$260.33
|
| Rate for Payer: Multiplan Commercial |
$297.52
|
| Rate for Payer: Networks By Design Commercial |
$241.74
|
| Rate for Payer: Prime Health Services Commercial |
$316.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$185.95
|
| Rate for Payer: United Healthcare All Other HMO |
$185.95
|
| Rate for Payer: United Healthcare HMO Rider |
$185.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$316.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$316.12
|
| Rate for Payer: Vantage Medical Group Senior |
$316.12
|
|
