|
HC CATH PENUMBRA SELECT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
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 PERITONEAL DIALYSIS PEDS
|
Facility
|
OP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Adventist Health Commercial |
$19.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.89
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$63.72
|
| Rate for Payer: Cigna of CA PPO |
$73.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: EPIC Health Plan Senior |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.69
|
| Rate for Payer: Multiplan Commercial |
$79.65
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.78
|
| Rate for Payer: United Healthcare All Other HMO |
$49.78
|
| Rate for Payer: United Healthcare HMO Rider |
$49.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.63
|
| Rate for Payer: Vantage Medical Group Senior |
$84.63
|
|
|
HC CATH PERITONEAL DIALYSIS PEDS
|
Facility
|
IP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Adventist Health Commercial |
$19.91
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: EPIC Health Plan Senior |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.89
|
| Rate for Payer: Multiplan Commercial |
$79.65
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,251.20 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$891.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,131.97
|
| Rate for Payer: Blue Shield of California Commercial |
$746.30
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,251.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$934.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$534.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,030.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,030.40
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$934.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.28
|
| Rate for Payer: Multiplan Commercial |
$1,177.60
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$333.52
|
| Rate for Payer: Blue Shield of California Commercial |
$279.36
|
| Rate for Payer: Blue Shield of California Commercial |
$423.72
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$200.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.24
|
| Rate for Payer: Multiplan Commercial |
$440.80
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
|
|
HC CATH PICC 5.5FR DL 55CM STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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 PICC 5.5FR DL 55CM STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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 PICC 5FR DL 55CM W/STYLET
|
Facility
|
OP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$1,814.24 |
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,173.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,600.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,291.95
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.14
|
| Rate for Payer: Blue Shield of California Commercial |
$1,641.35
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,814.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,814.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,494.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$774.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,494.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,494.08
|
| Rate for Payer: Multiplan Commercial |
$1,707.52
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,280.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,280.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,814.24
|
|
|
HC CATH PICC 5FR DL 55CM W/STYLET
|
Facility
|
IP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,494.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.26
|
| Rate for Payer: Multiplan Commercial |
$1,707.52
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,166.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,058.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.89
|
| Rate for Payer: Multiplan Commercial |
$1,332.97
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$1,416.28 |
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$916.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,249.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,008.56
|
| Rate for Payer: Blue Shield of California Commercial |
$1,281.32
|
| Rate for Payer: Blue Shield of California Commercial |
$844.77
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,416.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,416.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,166.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,058.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$604.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,166.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,166.35
|
| Rate for Payer: Multiplan Commercial |
$1,332.97
|
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$999.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$999.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Senior |
$1,416.28
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$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: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| 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 PICC DUAL LUMEN 1.9FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC INS TRAY NEONATAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH PICC INS TRAY NEONATAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$229.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.59
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
IP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$601.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$558.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.20
|
| Rate for Payer: Multiplan Commercial |
$757.34
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
OP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$804.68 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$520.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$710.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$573.03
|
| Rate for Payer: Blue Shield of California Commercial |
$479.97
|
| Rate for Payer: Blue Shield of California Commercial |
$728.00
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$804.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$804.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$804.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$601.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$343.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$558.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$662.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$662.68
|
| Rate for Payer: Multiplan Commercial |
$757.34
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$568.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$568.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$804.68
|
| Rate for Payer: Vantage Medical Group Senior |
$804.68
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
IP
|
$1,615.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cigna of CA HMO |
$1,130.51
|
| Rate for Payer: Cigna of CA PPO |
$1,130.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.76
|
| Rate for Payer: Global Benefits Group Commercial |
$969.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.60
|
| Rate for Payer: Multiplan Commercial |
$1,292.01
|
| Rate for Payer: Networks By Design Commercial |
$807.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.11
|
| Rate for Payer: United Healthcare All Other HMO |
$589.96
|
| Rate for Payer: United Healthcare HMO Rider |
$577.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.92
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
OP
|
$1,615.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$1,372.76 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$888.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,211.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$977.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,241.94
|
| Rate for Payer: Blue Shield of California Commercial |
$818.81
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cigna of CA HMO |
$1,130.51
|
| Rate for Payer: Cigna of CA PPO |
$1,130.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,372.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,372.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.76
|
| Rate for Payer: Global Benefits Group Commercial |
$969.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$586.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$387.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,130.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,130.51
|
| Rate for Payer: Multiplan Commercial |
$1,292.01
|
| Rate for Payer: Networks By Design Commercial |
$807.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$969.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$969.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.11
|
| Rate for Payer: United Healthcare All Other HMO |
$589.96
|
| Rate for Payer: United Healthcare HMO Rider |
$577.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,372.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,372.76
|
| Rate for Payer: Vantage Medical Group Senior |
$1,372.76
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
IP
|
$387.03
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.41 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$77.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cigna of CA HMO |
$270.92
|
| Rate for Payer: Cigna of CA PPO |
$270.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.81
|
| Rate for Payer: EPIC Health Plan Senior |
$154.81
|
| Rate for Payer: Galaxy Health WC |
$328.98
|
| Rate for Payer: Global Benefits Group Commercial |
$232.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$228.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.89
|
| Rate for Payer: Multiplan Commercial |
$309.62
|
| Rate for Payer: Networks By Design Commercial |
$193.51
|
| Rate for Payer: Prime Health Services Commercial |
$328.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.25
|
| Rate for Payer: United Healthcare All Other HMO |
$141.38
|
| Rate for Payer: United Healthcare HMO Rider |
$138.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.75
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
OP
|
$387.03
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.41 |
| Max. Negotiated Rate |
$328.98 |
| Rate for Payer: Adventist Health Commercial |
$77.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$290.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.27
|
| Rate for Payer: Blue Shield of California Commercial |
$196.22
|
| Rate for Payer: Blue Shield of California Commercial |
$297.63
|
| Rate for Payer: Cash Price |
$174.16
|
| Rate for Payer: Cigna of CA HMO |
$270.92
|
| Rate for Payer: Cigna of CA PPO |
$270.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.81
|
| Rate for Payer: EPIC Health Plan Senior |
$154.81
|
| Rate for Payer: Galaxy Health WC |
$328.98
|
| Rate for Payer: Global Benefits Group Commercial |
$232.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$228.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.92
|
| Rate for Payer: Multiplan Commercial |
$309.62
|
| Rate for Payer: Networks By Design Commercial |
$193.51
|
| Rate for Payer: Prime Health Services Commercial |
$328.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$232.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$232.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.25
|
| Rate for Payer: United Healthcare All Other HMO |
$141.38
|
| Rate for Payer: United Healthcare HMO Rider |
$138.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.98
|
| Rate for Payer: Vantage Medical Group Senior |
$328.98
|
|
