|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
IP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.78
|
| Rate for Payer: Multiplan Commercial |
$289.26
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
OP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$307.33 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$271.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.86
|
| Rate for Payer: Blue Shield of California Commercial |
$183.32
|
| Rate for Payer: Blue Shield of California Commercial |
$278.05
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$307.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$307.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$253.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$253.10
|
| Rate for Payer: Multiplan Commercial |
$289.26
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$216.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$216.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$307.33
|
| Rate for Payer: Vantage Medical Group Senior |
$307.33
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
IP
|
$386.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.28 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$77.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cigna of CA HMO |
$270.48
|
| Rate for Payer: Cigna of CA PPO |
$270.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.56
|
| Rate for Payer: EPIC Health Plan Senior |
$154.56
|
| Rate for Payer: Galaxy Health WC |
$328.44
|
| Rate for Payer: Global Benefits Group Commercial |
$231.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.74
|
| Rate for Payer: Multiplan Commercial |
$309.12
|
| Rate for Payer: Networks By Design Commercial |
$193.20
|
| Rate for Payer: Prime Health Services Commercial |
$328.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.02
|
| Rate for Payer: United Healthcare All Other HMO |
$141.15
|
| Rate for Payer: United Healthcare HMO Rider |
$138.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.55
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
OP
|
$386.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.28 |
| Max. Negotiated Rate |
$328.44 |
| Rate for Payer: Cigna of CA PPO |
$270.48
|
| Rate for Payer: Adventist Health Commercial |
$77.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$289.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.89
|
| Rate for Payer: Blue Shield of California Commercial |
$195.90
|
| Rate for Payer: Blue Shield of California Commercial |
$297.14
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cigna of CA HMO |
$270.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.56
|
| Rate for Payer: EPIC Health Plan Senior |
$154.56
|
| Rate for Payer: Galaxy Health WC |
$328.44
|
| Rate for Payer: Global Benefits Group Commercial |
$231.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.48
|
| Rate for Payer: Multiplan Commercial |
$309.12
|
| Rate for Payer: Networks By Design Commercial |
$193.20
|
| Rate for Payer: Prime Health Services Commercial |
$328.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.02
|
| Rate for Payer: United Healthcare All Other HMO |
$141.15
|
| Rate for Payer: United Healthcare HMO Rider |
$138.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.44
|
| Rate for Payer: Vantage Medical Group Senior |
$328.44
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$741.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$689.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.42
|
| Rate for Payer: Multiplan Commercial |
$934.72
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$993.14 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$642.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$876.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$707.23
|
| Rate for Payer: Blue Shield of California Commercial |
$592.38
|
| Rate for Payer: Blue Shield of California Commercial |
$898.50
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$993.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$993.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$993.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$741.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$689.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$817.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$817.88
|
| Rate for Payer: Multiplan Commercial |
$934.72
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$701.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$701.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$993.14
|
| Rate for Payer: Vantage Medical Group Senior |
$993.14
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
OP
|
$1,098.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.68 |
| Max. Negotiated Rate |
$933.63 |
| Rate for Payer: EPIC Health Plan Commercial |
$439.36
|
| Rate for Payer: EPIC Health Plan Senior |
$439.36
|
| Rate for Payer: Galaxy Health WC |
$933.63
|
| Rate for Payer: Adventist Health Commercial |
$219.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$933.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$604.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$823.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$664.86
|
| Rate for Payer: Blue Shield of California Commercial |
$556.88
|
| Rate for Payer: Blue Shield of California Commercial |
$844.66
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cigna of CA HMO |
$768.87
|
| Rate for Payer: Cigna of CA PPO |
$768.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$933.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$933.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$933.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$768.87
|
| Rate for Payer: Global Benefits Group Commercial |
$659.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$697.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$398.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$648.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$768.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$768.87
|
| Rate for Payer: Multiplan Commercial |
$878.71
|
| Rate for Payer: Networks By Design Commercial |
$549.20
|
| Rate for Payer: Prime Health Services Commercial |
$933.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$659.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$659.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$412.23
|
| Rate for Payer: United Healthcare All Other HMO |
$401.24
|
| Rate for Payer: United Healthcare HMO Rider |
$392.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$359.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$933.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$933.63
|
| Rate for Payer: Vantage Medical Group Senior |
$933.63
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
IP
|
$1,098.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.68 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$219.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cash Price |
$494.28
|
| Rate for Payer: Cigna of CA HMO |
$768.87
|
| Rate for Payer: Cigna of CA PPO |
$768.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$768.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.36
|
| Rate for Payer: EPIC Health Plan Senior |
$439.36
|
| Rate for Payer: Galaxy Health WC |
$933.63
|
| Rate for Payer: Global Benefits Group Commercial |
$659.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$697.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$648.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.61
|
| Rate for Payer: Multiplan Commercial |
$878.71
|
| Rate for Payer: Networks By Design Commercial |
$549.20
|
| Rate for Payer: Prime Health Services Commercial |
$933.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$412.23
|
| Rate for Payer: United Healthcare All Other HMO |
$401.24
|
| Rate for Payer: United Healthcare HMO Rider |
$392.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$359.72
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
OP
|
$2,086.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.28 |
| Max. Negotiated Rate |
$1,773.46 |
| Rate for Payer: Adventist Health Commercial |
$417.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,147.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,564.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,262.91
|
| Rate for Payer: Blue Shield of California Commercial |
$1,057.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,604.46
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cigna of CA HMO |
$1,460.49
|
| Rate for Payer: Cigna of CA PPO |
$1,460.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,773.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,773.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,460.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.57
|
| Rate for Payer: EPIC Health Plan Senior |
$834.57
|
| Rate for Payer: Galaxy Health WC |
$1,773.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,324.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$757.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,230.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,460.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,460.49
|
| Rate for Payer: Multiplan Commercial |
$1,669.14
|
| Rate for Payer: Networks By Design Commercial |
$1,043.21
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,251.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,251.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.03
|
| Rate for Payer: United Healthcare All Other HMO |
$762.17
|
| Rate for Payer: United Healthcare HMO Rider |
$745.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,773.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,773.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1,773.46
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
IP
|
$2,086.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.28 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$417.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cash Price |
$938.89
|
| Rate for Payer: Cigna of CA HMO |
$1,460.49
|
| Rate for Payer: Cigna of CA PPO |
$1,460.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,460.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$834.57
|
| Rate for Payer: EPIC Health Plan Senior |
$834.57
|
| Rate for Payer: Galaxy Health WC |
$1,773.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1,251.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,324.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,230.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.74
|
| Rate for Payer: Multiplan Commercial |
$1,669.14
|
| Rate for Payer: Networks By Design Commercial |
$1,043.21
|
| Rate for Payer: Prime Health Services Commercial |
$1,773.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.03
|
| Rate for Payer: United Healthcare All Other HMO |
$762.17
|
| Rate for Payer: United Healthcare HMO Rider |
$745.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.30
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$543.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$741.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$598.64
|
| Rate for Payer: Blue Shield of California Commercial |
$501.42
|
| Rate for Payer: Blue Shield of California Commercial |
$760.54
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$840.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$840.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$840.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$359.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$692.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$692.30
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$840.65
|
| Rate for Payer: Vantage Medical Group Senior |
$840.65
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,090.89 |
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$962.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$776.84
|
| Rate for Payer: Blue Shield of California Commercial |
$650.68
|
| Rate for Payer: Blue Shield of California Commercial |
$986.93
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,090.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$814.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$465.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$757.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$898.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$898.38
|
| Rate for Payer: Multiplan Commercial |
$1,026.72
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$814.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$757.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.02
|
| Rate for Payer: Multiplan Commercial |
$1,026.72
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
OP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$1,144.34 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$740.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,009.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$814.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,035.29
|
| Rate for Payer: Blue Shield of California Commercial |
$682.56
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,144.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,144.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$488.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$942.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$942.40
|
| Rate for Payer: Multiplan Commercial |
$1,077.02
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$807.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$807.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,144.34
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
IP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cash Price |
$605.83
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.11
|
| Rate for Payer: Multiplan Commercial |
$1,077.02
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,051.79 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$749.00
|
| Rate for Payer: Blue Shield of California Commercial |
$627.36
|
| Rate for Payer: Blue Shield of California Commercial |
$951.56
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$785.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$449.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$785.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,051.79 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$749.00
|
| Rate for Payer: Blue Shield of California Commercial |
$627.36
|
| Rate for Payer: Blue Shield of California Commercial |
$951.56
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$785.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$449.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$785.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.98
|
| Rate for Payer: Multiplan Commercial |
$989.92
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
IP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,062.19 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Cash Price |
$562.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$737.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.91
|
| Rate for Payer: Multiplan Commercial |
$999.71
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
OP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$687.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$937.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$801.89
|
| Rate for Payer: Cash Price |
$562.34
|
| Rate for Payer: Cash Price |
$562.34
|
| Rate for Payer: Cigna of CA HMO |
$799.77
|
| Rate for Payer: Cigna of CA PPO |
$924.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,062.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$453.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$737.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$874.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$874.75
|
| Rate for Payer: Multiplan Commercial |
$999.71
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.82
|
| Rate for Payer: United Healthcare All Other HMO |
$624.82
|
| Rate for Payer: United Healthcare HMO Rider |
$624.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
IP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,158.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,051.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$976.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.33
|
| Rate for Payer: Multiplan Commercial |
$1,324.43
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
OP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$1,407.21 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$910.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,241.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,002.10
|
| Rate for Payer: Blue Shield of California Commercial |
$1,273.11
|
| Rate for Payer: Blue Shield of California Commercial |
$839.36
|
| Rate for Payer: Cash Price |
$744.99
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,407.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,407.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,158.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,051.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$600.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$976.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,158.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,158.88
|
| Rate for Payer: Multiplan Commercial |
$1,324.43
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$993.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$993.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Senior |
$1,407.21
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
OP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$779.07 |
| Rate for Payer: Adventist Health Commercial |
$183.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$504.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$554.79
|
| Rate for Payer: Blue Shield of California Commercial |
$464.69
|
| Rate for Payer: Blue Shield of California Commercial |
$704.83
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Cigna of CA HMO |
$641.59
|
| Rate for Payer: Cigna of CA PPO |
$641.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$779.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$779.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$779.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$641.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Senior |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$582.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$332.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$540.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$641.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$641.59
|
| Rate for Payer: Multiplan Commercial |
$733.24
|
| Rate for Payer: Networks By Design Commercial |
$458.27
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$549.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$549.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.98
|
| Rate for Payer: United Healthcare All Other HMO |
$334.82
|
| Rate for Payer: United Healthcare HMO Rider |
$327.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$779.07
|
| Rate for Payer: Vantage Medical Group Senior |
$779.07
|
|
