|
HC CATH HEMO KIT 2LUMEN 12FRX13CM
|
Facility
|
IP
|
$849.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.83 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$169.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cigna of CA HMO |
$594.41
|
| Rate for Payer: Cigna of CA PPO |
$594.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.66
|
| Rate for Payer: EPIC Health Plan Senior |
$339.66
|
| Rate for Payer: Galaxy Health WC |
$721.79
|
| Rate for Payer: Global Benefits Group Commercial |
$509.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$679.33
|
| Rate for Payer: Networks By Design Commercial |
$424.58
|
| Rate for Payer: Prime Health Services Commercial |
$721.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.69
|
| Rate for Payer: United Healthcare All Other HMO |
$310.20
|
| Rate for Payer: United Healthcare HMO Rider |
$303.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.10
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX13CM
|
Facility
|
OP
|
$849.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.83 |
| Max. Negotiated Rate |
$721.79 |
| Rate for Payer: Adventist Health Commercial |
$169.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$721.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$636.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.00
|
| Rate for Payer: Blue Shield of California Commercial |
$430.52
|
| Rate for Payer: Blue Shield of California Commercial |
$653.00
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cigna of CA HMO |
$594.41
|
| Rate for Payer: Cigna of CA PPO |
$594.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$721.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$721.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$721.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.66
|
| Rate for Payer: EPIC Health Plan Senior |
$339.66
|
| Rate for Payer: Galaxy Health WC |
$721.79
|
| Rate for Payer: Global Benefits Group Commercial |
$509.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$308.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$594.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$594.41
|
| Rate for Payer: Multiplan Commercial |
$679.33
|
| Rate for Payer: Networks By Design Commercial |
$424.58
|
| Rate for Payer: Prime Health Services Commercial |
$721.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$509.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$509.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.69
|
| Rate for Payer: United Healthcare All Other HMO |
$310.20
|
| Rate for Payer: United Healthcare HMO Rider |
$303.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$721.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$721.79
|
| Rate for Payer: Vantage Medical Group Senior |
$721.79
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$849.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.83 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$169.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cigna of CA HMO |
$594.41
|
| Rate for Payer: Cigna of CA PPO |
$594.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.66
|
| Rate for Payer: EPIC Health Plan Senior |
$339.66
|
| Rate for Payer: Galaxy Health WC |
$721.79
|
| Rate for Payer: Global Benefits Group Commercial |
$509.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$679.33
|
| Rate for Payer: Networks By Design Commercial |
$424.58
|
| Rate for Payer: Prime Health Services Commercial |
$721.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.69
|
| Rate for Payer: United Healthcare All Other HMO |
$310.20
|
| Rate for Payer: United Healthcare HMO Rider |
$303.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.10
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$849.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.83 |
| Max. Negotiated Rate |
$721.79 |
| Rate for Payer: Adventist Health Commercial |
$169.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$721.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$636.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.00
|
| Rate for Payer: Blue Shield of California Commercial |
$430.52
|
| Rate for Payer: Blue Shield of California Commercial |
$653.00
|
| Rate for Payer: Cash Price |
$382.12
|
| Rate for Payer: Cigna of CA HMO |
$594.41
|
| Rate for Payer: Cigna of CA PPO |
$594.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$721.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$721.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$721.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$594.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.66
|
| Rate for Payer: EPIC Health Plan Senior |
$339.66
|
| Rate for Payer: Galaxy Health WC |
$721.79
|
| Rate for Payer: Global Benefits Group Commercial |
$509.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$308.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$594.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$594.41
|
| Rate for Payer: Multiplan Commercial |
$679.33
|
| Rate for Payer: Networks By Design Commercial |
$424.58
|
| Rate for Payer: Prime Health Services Commercial |
$721.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$509.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$509.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.69
|
| Rate for Payer: United Healthcare All Other HMO |
$310.20
|
| Rate for Payer: United Healthcare HMO Rider |
$303.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$721.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$721.79
|
| Rate for Payer: Vantage Medical Group Senior |
$721.79
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.43
|
| Rate for Payer: Blue Shield of California Commercial |
$131.03
|
| Rate for Payer: Blue Shield of California Commercial |
$198.74
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$93.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.43
|
| Rate for Payer: Blue Shield of California Commercial |
$131.03
|
| Rate for Payer: Blue Shield of California Commercial |
$198.74
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$93.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$872.16
|
|
| Hospital Charge Code |
901698977
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$174.43 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$174.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$392.47
|
| Rate for Payer: Cash Price |
$392.47
|
| Rate for Payer: Cigna of CA HMO |
$610.51
|
| Rate for Payer: Cigna of CA PPO |
$610.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$610.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.86
|
| Rate for Payer: EPIC Health Plan Senior |
$348.86
|
| Rate for Payer: Galaxy Health WC |
$741.34
|
| Rate for Payer: Global Benefits Group Commercial |
$523.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$514.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.32
|
| Rate for Payer: Multiplan Commercial |
$697.73
|
| Rate for Payer: Networks By Design Commercial |
$436.08
|
| Rate for Payer: Prime Health Services Commercial |
$741.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$327.32
|
| Rate for Payer: United Healthcare All Other HMO |
$318.60
|
| Rate for Payer: United Healthcare HMO Rider |
$311.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.63
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$872.16
|
|
| Hospital Charge Code |
901698977
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$174.43 |
| Max. Negotiated Rate |
$741.34 |
| Rate for Payer: Adventist Health Commercial |
$174.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$741.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$479.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$527.92
|
| Rate for Payer: Blue Shield of California Commercial |
$442.19
|
| Rate for Payer: Blue Shield of California Commercial |
$670.69
|
| Rate for Payer: Cash Price |
$392.47
|
| Rate for Payer: Cigna of CA HMO |
$610.51
|
| Rate for Payer: Cigna of CA PPO |
$610.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$741.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$741.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$610.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.86
|
| Rate for Payer: EPIC Health Plan Senior |
$348.86
|
| Rate for Payer: Galaxy Health WC |
$741.34
|
| Rate for Payer: Global Benefits Group Commercial |
$523.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$316.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$514.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$610.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$610.51
|
| Rate for Payer: Multiplan Commercial |
$697.73
|
| Rate for Payer: Networks By Design Commercial |
$436.08
|
| Rate for Payer: Prime Health Services Commercial |
$741.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$523.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$327.32
|
| Rate for Payer: United Healthcare All Other HMO |
$318.60
|
| Rate for Payer: United Healthcare HMO Rider |
$311.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$741.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.34
|
| Rate for Payer: Vantage Medical Group Senior |
$741.34
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX25CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX25CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.43
|
| Rate for Payer: Blue Shield of California Commercial |
$131.03
|
| Rate for Payer: Blue Shield of California Commercial |
$198.74
|
| Rate for Payer: Cash Price |
$116.30
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$93.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$206.75
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
|
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$468.45 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$333.59
|
| Rate for Payer: Blue Shield of California Commercial |
$279.42
|
| Rate for Payer: Blue Shield of California Commercial |
$423.81
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$200.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.78
|
| Rate for Payer: Multiplan Commercial |
$440.90
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
|
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.27
|
| Rate for Payer: Multiplan Commercial |
$440.90
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
|
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$468.45 |
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$333.59
|
| Rate for Payer: Blue Shield of California Commercial |
$279.42
|
| Rate for Payer: Blue Shield of California Commercial |
$423.81
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$200.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.78
|
| Rate for Payer: Multiplan Commercial |
$440.90
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
|
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.27
|
| Rate for Payer: Multiplan Commercial |
$440.90
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$294.06
|
| Rate for Payer: Blue Shield of California Commercial |
$446.02
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH HICKMAN 7FR
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,475.91
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,392.19
|
| Rate for Payer: Blue Shield of California Commercial |
$1,166.10
|
| Rate for Payer: Blue Shield of California Commercial |
$1,768.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,460.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$834.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$294.06
|
| Rate for Payer: Blue Shield of California Commercial |
$446.02
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
IP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$279.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.81
|
| Rate for Payer: Multiplan Commercial |
$352.69
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
|
