|
HC CATH MALE EXT .30MM SPORT
|
Facility
|
IP
|
$8.45
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$7.18 |
| Rate for Payer: Adventist Health Commercial |
$1.69
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.38
|
| Rate for Payer: EPIC Health Plan Senior |
$3.38
|
| Rate for Payer: Galaxy Health WC |
$7.18
|
| Rate for Payer: Global Benefits Group Commercial |
$5.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.03
|
| Rate for Payer: Multiplan Commercial |
$6.76
|
| Rate for Payer: Networks By Design Commercial |
$5.49
|
| Rate for Payer: Prime Health Services Commercial |
$7.18
|
|
|
HC CATH MALE EXT .30MM STANDARD
|
Facility
|
OP
|
$8.36
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.36
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cigna of CA HMO |
$5.35
|
| Rate for Payer: Cigna of CA PPO |
$6.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.85
|
| Rate for Payer: Multiplan Commercial |
$6.69
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO |
$4.18
|
| Rate for Payer: United Healthcare HMO Rider |
$4.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.11
|
| Rate for Payer: Vantage Medical Group Senior |
$7.11
|
|
|
HC CATH MALE EXT .30MM STANDARD
|
Facility
|
IP
|
$8.36
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: Multiplan Commercial |
$6.69
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
|
|
HC CATH MALE EXT .35MM SPORT
|
Facility
|
IP
|
$8.45
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$7.18 |
| Rate for Payer: Adventist Health Commercial |
$1.69
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.38
|
| Rate for Payer: EPIC Health Plan Senior |
$3.38
|
| Rate for Payer: Galaxy Health WC |
$7.18
|
| Rate for Payer: Global Benefits Group Commercial |
$5.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.03
|
| Rate for Payer: Multiplan Commercial |
$6.76
|
| Rate for Payer: Networks By Design Commercial |
$5.49
|
| Rate for Payer: Prime Health Services Commercial |
$7.18
|
|
|
HC CATH MALE EXT .35MM SPORT
|
Facility
|
OP
|
$8.45
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$7.18 |
| Rate for Payer: Adventist Health Commercial |
$1.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.42
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Cigna of CA HMO |
$5.41
|
| Rate for Payer: Cigna of CA PPO |
$6.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.38
|
| Rate for Payer: EPIC Health Plan Senior |
$3.38
|
| Rate for Payer: Galaxy Health WC |
$7.18
|
| Rate for Payer: Global Benefits Group Commercial |
$5.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.92
|
| Rate for Payer: Multiplan Commercial |
$6.76
|
| Rate for Payer: Networks By Design Commercial |
$5.49
|
| Rate for Payer: Prime Health Services Commercial |
$7.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.22
|
| Rate for Payer: United Healthcare All Other HMO |
$4.22
|
| Rate for Payer: United Healthcare HMO Rider |
$4.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.18
|
| Rate for Payer: Vantage Medical Group Senior |
$7.18
|
|
|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
OP
|
$8.36
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.36
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cigna of CA HMO |
$5.35
|
| Rate for Payer: Cigna of CA PPO |
$6.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.85
|
| Rate for Payer: Multiplan Commercial |
$6.69
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO |
$4.18
|
| Rate for Payer: United Healthcare HMO Rider |
$4.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.11
|
| Rate for Payer: Vantage Medical Group Senior |
$7.11
|
|
|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
IP
|
$8.36
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: Multiplan Commercial |
$6.69
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
IP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.49 |
| Rate for Payer: Multiplan Commercial |
$6.10
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.83
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
OP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.49 |
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.90
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cigna of CA HMO |
$4.88
|
| Rate for Payer: Cigna of CA PPO |
$5.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.34
|
| Rate for Payer: Multiplan Commercial |
$6.10
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.81
|
| Rate for Payer: United Healthcare All Other HMO |
$3.81
|
| Rate for Payer: United Healthcare HMO Rider |
$3.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.49
|
| Rate for Payer: Vantage Medical Group Senior |
$6.49
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$213.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.23
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$108.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH MED NIH
|
Facility
|
IP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$451.35 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$371.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$337.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$313.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.44
|
| Rate for Payer: Multiplan Commercial |
$424.80
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC CATH MED NIH
|
Facility
|
OP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$451.35 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$398.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.74
|
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$451.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$371.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$337.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$313.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.70
|
| Rate for Payer: Multiplan Commercial |
$424.80
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$265.50
|
| Rate for Payer: United Healthcare All Other HMO |
$265.50
|
| Rate for Payer: United Healthcare HMO Rider |
$265.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC CATH MERIT MOD V
|
Facility
|
OP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$213.43 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$213.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.84
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Cigna of CA HMO |
$65.66
|
| Rate for Payer: Cigna of CA PPO |
$75.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.82
|
| Rate for Payer: Multiplan Commercial |
$82.08
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.30
|
| Rate for Payer: United Healthcare All Other HMO |
$51.30
|
| Rate for Payer: United Healthcare HMO Rider |
$51.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.21
|
| Rate for Payer: Vantage Medical Group Senior |
$87.21
|
|
|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.62
|
| Rate for Payer: Multiplan Commercial |
$82.08
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
OP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.25
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: Cigna of CA HMO |
$44.13
|
| Rate for Payer: Cigna of CA PPO |
$51.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.27
|
| Rate for Payer: Multiplan Commercial |
$55.17
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.48
|
| Rate for Payer: United Healthcare All Other HMO |
$34.48
|
| Rate for Payer: United Healthcare HMO Rider |
$34.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.62
|
| Rate for Payer: Vantage Medical Group Senior |
$58.62
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
IP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.55
|
| Rate for Payer: Multiplan Commercial |
$55.17
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 3FR 20CM SL CDC
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
OP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$904.70 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$644.25
|
| Rate for Payer: Blue Shield of California Commercial |
$539.63
|
| Rate for Payer: Blue Shield of California Commercial |
$818.49
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$904.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$904.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$904.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$675.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$386.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$627.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.04
|
| Rate for Payer: Multiplan Commercial |
$851.48
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$638.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$638.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$904.70
|
| Rate for Payer: Vantage Medical Group Senior |
$904.70
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
IP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$675.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$627.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.44
|
| Rate for Payer: Multiplan Commercial |
$851.48
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
OP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$618.05 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$545.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$440.13
|
| Rate for Payer: Blue Shield of California Commercial |
$368.65
|
| Rate for Payer: Blue Shield of California Commercial |
$559.16
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$618.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$618.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$618.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$461.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$263.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.98
|
| Rate for Payer: Multiplan Commercial |
$581.70
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$436.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$618.05
|
| Rate for Payer: Vantage Medical Group Senior |
$618.05
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
IP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$461.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.51
|
| Rate for Payer: Multiplan Commercial |
$581.70
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
|
|
HC CATH MIDLINE 4FR SL CDC KIT
|
Facility
|
OP
|
$770.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.19 |
| Max. Negotiated Rate |
$655.32 |
| Rate for Payer: Adventist Health Commercial |
$154.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$655.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$424.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$578.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$466.66
|
| Rate for Payer: Blue Shield of California Commercial |
$390.88
|
| Rate for Payer: Blue Shield of California Commercial |
$592.87
|
| Rate for Payer: Cash Price |
$346.93
|
| Rate for Payer: Cigna of CA HMO |
$539.67
|
| Rate for Payer: Cigna of CA PPO |
$539.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$655.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$655.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$655.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$539.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$308.38
|
| Rate for Payer: EPIC Health Plan Senior |
$308.38
|
| Rate for Payer: Galaxy Health WC |
$655.32
|
| Rate for Payer: Global Benefits Group Commercial |
$462.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$489.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$279.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$454.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$539.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$539.67
|
| Rate for Payer: Multiplan Commercial |
$616.77
|
| Rate for Payer: Networks By Design Commercial |
$385.48
|
| Rate for Payer: Prime Health Services Commercial |
$655.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$462.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$462.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.34
|
| Rate for Payer: United Healthcare All Other HMO |
$281.63
|
| Rate for Payer: United Healthcare HMO Rider |
$275.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$252.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$655.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$655.32
|
| Rate for Payer: Vantage Medical Group Senior |
$655.32
|
|
|
HC CATH MIDLINE 4FR SL CDC KIT
|
Facility
|
IP
|
$770.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.19 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$154.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$346.93
|
| Rate for Payer: Cash Price |
$346.93
|
| Rate for Payer: Cigna of CA HMO |
$539.67
|
| Rate for Payer: Cigna of CA PPO |
$539.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$539.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$308.38
|
| Rate for Payer: EPIC Health Plan Senior |
$308.38
|
| Rate for Payer: Galaxy Health WC |
$655.32
|
| Rate for Payer: Global Benefits Group Commercial |
$462.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$489.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$454.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.03
|
| Rate for Payer: Multiplan Commercial |
$616.77
|
| Rate for Payer: Networks By Design Commercial |
$385.48
|
| Rate for Payer: Prime Health Services Commercial |
$655.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.34
|
| Rate for Payer: United Healthcare All Other HMO |
$281.63
|
| Rate for Payer: United Healthcare HMO Rider |
$275.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$252.49
|
|
