|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.26
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.26
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.26
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,050.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,675.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,333.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,097.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,260.00
|
| Rate for Payer: Multiplan Commercial |
$4,200.00
|
| Rate for Payer: Networks By Design Commercial |
$2,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,970.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1,917.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1,876.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.38
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$4,462.50 |
| Rate for Payer: Adventist Health Commercial |
$1,050.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,937.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,177.82
|
| Rate for Payer: Blue Shield of California Commercial |
$2,661.75
|
| Rate for Payer: Blue Shield of California Commercial |
$4,037.25
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,462.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,462.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,675.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,333.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,905.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,097.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,260.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,675.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,675.00
|
| Rate for Payer: Multiplan Commercial |
$4,200.00
|
| Rate for Payer: Networks By Design Commercial |
$2,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,970.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1,917.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1,876.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,462.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,462.50
|
|
|
HC CATH KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$652.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$526.25
|
| Rate for Payer: Blue Shield of California Commercial |
$440.79
|
| Rate for Payer: Blue Shield of California Commercial |
$668.57
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$738.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$315.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$512.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.58
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.29
|
| Rate for Payer: United Healthcare All Other HMO |
$317.59
|
| Rate for Payer: United Healthcare HMO Rider |
$310.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$284.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$512.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.29
|
| Rate for Payer: United Healthcare All Other HMO |
$317.59
|
| Rate for Payer: United Healthcare HMO Rider |
$310.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$284.73
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
OP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$397.26 |
| Rate for Payer: Adventist Health Commercial |
$93.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$397.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.89
|
| Rate for Payer: Blue Shield of California Commercial |
$236.95
|
| Rate for Payer: Blue Shield of California Commercial |
$359.40
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$397.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$397.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$397.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$327.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Senior |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$296.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$327.15
|
| Rate for Payer: Multiplan Commercial |
$373.89
|
| Rate for Payer: Networks By Design Commercial |
$233.68
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$280.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO |
$170.73
|
| Rate for Payer: United Healthcare HMO Rider |
$167.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$397.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$397.26
|
| Rate for Payer: Vantage Medical Group Senior |
$397.26
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
IP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$93.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$327.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Senior |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$296.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.17
|
| Rate for Payer: Multiplan Commercial |
$373.89
|
| Rate for Payer: Networks By Design Commercial |
$233.68
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO |
$170.73
|
| Rate for Payer: United Healthcare HMO Rider |
$167.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.06
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
IP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$91.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Senior |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$271.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.29
|
| Rate for Payer: Multiplan Commercial |
$367.62
|
| Rate for Payer: Networks By Design Commercial |
$229.76
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.46
|
| Rate for Payer: United Healthcare All Other HMO |
$167.87
|
| Rate for Payer: United Healthcare HMO Rider |
$164.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
OP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$390.60 |
| Rate for Payer: Adventist Health Commercial |
$91.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$344.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$278.15
|
| Rate for Payer: Blue Shield of California Commercial |
$232.98
|
| Rate for Payer: Blue Shield of California Commercial |
$353.38
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$390.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Senior |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$166.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$271.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$321.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$321.67
|
| Rate for Payer: Multiplan Commercial |
$367.62
|
| Rate for Payer: Networks By Design Commercial |
$229.76
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.46
|
| Rate for Payer: United Healthcare All Other HMO |
$167.87
|
| Rate for Payer: United Healthcare HMO Rider |
$164.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.60
|
| Rate for Payer: Vantage Medical Group Senior |
$390.60
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
OP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: United Healthcare HMO Rider |
$21.86
|
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.05
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Cigna of CA HMO |
$27.97
|
| Rate for Payer: Cigna of CA PPO |
$32.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO |
$21.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.15
|
| Rate for Payer: Vantage Medical Group Senior |
$37.15
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
IP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
|
|
HC CATH KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
IP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: Adventist Health Commercial |
$192.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Senior |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$567.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.74
|
| Rate for Payer: Multiplan Commercial |
$769.12
|
| Rate for Payer: Networks By Design Commercial |
$480.70
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$360.81
|
| Rate for Payer: United Healthcare All Other HMO |
$351.20
|
| Rate for Payer: United Healthcare HMO Rider |
$343.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.86
|
|
|
HC CATH KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
OP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$817.19 |
| Rate for Payer: Adventist Health Commercial |
$192.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$721.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$581.94
|
| Rate for Payer: Blue Shield of California Commercial |
$487.43
|
| Rate for Payer: Blue Shield of California Commercial |
$739.32
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$817.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$817.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$817.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$672.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Senior |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$610.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$348.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$567.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$672.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$672.98
|
| Rate for Payer: Multiplan Commercial |
$769.12
|
| Rate for Payer: Networks By Design Commercial |
$480.70
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$360.81
|
| Rate for Payer: United Healthcare All Other HMO |
$351.20
|
| Rate for Payer: United Healthcare HMO Rider |
$343.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$817.19
|
| Rate for Payer: Vantage Medical Group Senior |
$817.19
|
|
|
HC CATH KIT VASCU-PICC 2.6FR SL
|
Facility
|
IP
|
$1,062.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.52 |
| Max. Negotiated Rate |
$903.21 |
| Rate for Payer: Adventist Health Commercial |
$212.52
|
| Rate for Payer: Cash Price |
$478.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$743.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.04
|
| Rate for Payer: EPIC Health Plan Senior |
$425.04
|
| Rate for Payer: Galaxy Health WC |
$903.21
|
| Rate for Payer: Global Benefits Group Commercial |
$637.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$674.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$626.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.02
|
| Rate for Payer: Multiplan Commercial |
$850.08
|
| Rate for Payer: Networks By Design Commercial |
$690.69
|
| Rate for Payer: Prime Health Services Commercial |
$903.21
|
|
|
HC CATH KIT VASCU-PICC 2.6FR SL
|
Facility
|
OP
|
$1,062.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.52 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$212.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$903.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$796.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$681.87
|
| Rate for Payer: Cash Price |
$478.17
|
| Rate for Payer: Cash Price |
$478.17
|
| Rate for Payer: Cigna of CA HMO |
$680.06
|
| Rate for Payer: Cigna of CA PPO |
$786.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$903.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$903.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$903.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$743.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.04
|
| Rate for Payer: EPIC Health Plan Senior |
$425.04
|
| Rate for Payer: Galaxy Health WC |
$903.21
|
| Rate for Payer: Global Benefits Group Commercial |
$637.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$674.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$385.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$626.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$743.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$743.82
|
| Rate for Payer: Multiplan Commercial |
$850.08
|
| Rate for Payer: Networks By Design Commercial |
$690.69
|
| Rate for Payer: Prime Health Services Commercial |
$903.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.30
|
| Rate for Payer: United Healthcare All Other HMO |
$531.30
|
| Rate for Payer: United Healthcare HMO Rider |
$531.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$903.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$903.21
|
| Rate for Payer: Vantage Medical Group Senior |
$903.21
|
|
|
HC CATH LNRD 10FR REPAIR SGMNT
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
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 LNRD 10FR REPAIR SGMNT
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
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 LO FRIC 14FR COUDE
|
Facility
|
OP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.73
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cigna of CA HMO |
$12.70
|
| Rate for Payer: Cigna of CA PPO |
$14.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.89
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.92
|
| Rate for Payer: United Healthcare All Other HMO |
$9.92
|
| Rate for Payer: United Healthcare HMO Rider |
$9.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.86
|
| Rate for Payer: Vantage Medical Group Senior |
$16.86
|
|
|
HC CATH LO FRIC 14FR COUDE
|
Facility
|
IP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.76
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
|
|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
