|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
IP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$649.98
|
| Rate for Payer: Cash Price |
$649.98
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$852.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.66
|
| Rate for Payer: Multiplan Commercial |
$1,155.52
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
|
|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
OP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$1,227.74 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$794.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,083.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$874.30
|
| Rate for Payer: Blue Shield of California Commercial |
$1,110.74
|
| Rate for Payer: Blue Shield of California Commercial |
$732.31
|
| Rate for Payer: Cash Price |
$649.98
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,227.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,227.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$524.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$852.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,011.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,011.08
|
| Rate for Payer: Multiplan Commercial |
$1,155.52
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$866.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$866.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Senior |
$1,227.74
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
OP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$1,259.92 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$815.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,111.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$897.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1,139.86
|
| Rate for Payer: Blue Shield of California Commercial |
$751.51
|
| Rate for Payer: Cash Price |
$667.02
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,259.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,259.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,037.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$941.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$538.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$874.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$355.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,037.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,037.58
|
| Rate for Payer: Multiplan Commercial |
$1,185.81
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$889.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$889.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Senior |
$1,259.92
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
IP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$667.02
|
| Rate for Payer: Cash Price |
$667.02
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,037.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$941.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$874.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$355.74
|
| Rate for Payer: Multiplan Commercial |
$1,185.81
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
|
|
HC CATH PICC PWR 6FR TL 40CM VPS
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,090.89 |
| 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: Networks By Design Commercial |
$641.70
|
| 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 PWR 6FR TL 40CM VPS
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607741
|
|
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 PWR 6FR TL 55CM VPS
|
Facility
|
IP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$681.71
|
| Rate for Payer: Cash Price |
$681.71
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,060.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.58
|
| Rate for Payer: Multiplan Commercial |
$1,211.94
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
|
|
HC CATH PICC PWR 6FR TL 55CM VPS
|
Facility
|
OP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$1,287.68 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$833.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,136.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$916.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1,164.97
|
| Rate for Payer: Blue Shield of California Commercial |
$768.06
|
| Rate for Payer: Cash Price |
$681.71
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,287.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,287.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,060.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$549.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,060.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,060.44
|
| Rate for Payer: Multiplan Commercial |
$1,211.94
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$908.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$908.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,287.68
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| 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 |
$211.85
|
| Rate for Payer: Blue Shield of California Commercial |
$177.45
|
| Rate for Payer: Blue Shield of California Commercial |
$269.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| 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 |
$175.00
|
| 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 |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| 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 SILICONE 1.9FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| 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 |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH PICC SL ARROW VPS STYLET
|
Facility
|
OP
|
$1,674.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$334.88 |
| Max. Negotiated Rate |
$1,423.24 |
| Rate for Payer: Adventist Health Commercial |
$334.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$920.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,255.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,013.51
|
| Rate for Payer: Blue Shield of California Commercial |
$1,287.61
|
| Rate for Payer: Blue Shield of California Commercial |
$848.92
|
| Rate for Payer: Cash Price |
$753.48
|
| Rate for Payer: Cigna of CA HMO |
$1,172.08
|
| Rate for Payer: Cigna of CA PPO |
$1,172.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,423.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,423.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Senior |
$669.76
|
| Rate for Payer: Galaxy Health WC |
$1,423.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$607.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,172.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,172.08
|
| Rate for Payer: Multiplan Commercial |
$1,339.52
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,004.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,004.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.40
|
| Rate for Payer: United Healthcare All Other HMO |
$611.66
|
| Rate for Payer: United Healthcare HMO Rider |
$598.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,423.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,423.24
|
|
|
HC CATH PICC SL ARROW VPS STYLET
|
Facility
|
IP
|
$1,674.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$334.88 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$334.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$753.48
|
| Rate for Payer: Cash Price |
$753.48
|
| Rate for Payer: Cigna of CA HMO |
$1,172.08
|
| Rate for Payer: Cigna of CA PPO |
$1,172.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Senior |
$669.76
|
| Rate for Payer: Galaxy Health WC |
$1,423.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.86
|
| Rate for Payer: Multiplan Commercial |
$1,339.52
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.40
|
| Rate for Payer: United Healthcare All Other HMO |
$611.66
|
| Rate for Payer: United Healthcare HMO Rider |
$598.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.37
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$649.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$367.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$708.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$809.60
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
OP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$361.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$492.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.40
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Cigna of CA HMO |
$420.29
|
| Rate for Payer: Cigna of CA PPO |
$485.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$558.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$558.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$387.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$459.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$459.69
|
| Rate for Payer: Multiplan Commercial |
$525.36
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.35
|
| Rate for Payer: United Healthcare All Other HMO |
$328.35
|
| Rate for Payer: United Healthcare HMO Rider |
$328.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.20
|
| Rate for Payer: Vantage Medical Group Senior |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
IP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$558.20 |
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Multiplan Commercial |
$525.36
|
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$387.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.61
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| 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 |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| 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 |
$372.19
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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 PIGTAIL 5.5F 70CM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.47
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Cigna of CA HMO |
$72.28
|
| Rate for Payer: Cigna of CA PPO |
$83.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.47
|
| Rate for Payer: United Healthcare All Other HMO |
$56.47
|
| Rate for Payer: United Healthcare HMO Rider |
$56.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
OP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$96.97 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.21
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.86
|
| Rate for Payer: Multiplan Commercial |
$91.26
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
IP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$96.97 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.38
|
| Rate for Payer: Multiplan Commercial |
$91.26
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
IP
|
$609.50
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Cigna of CA HMO |
$426.65
|
| Rate for Payer: Cigna of CA PPO |
$426.65
|
| Rate for Payer: Adventist Health Commercial |
$121.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$426.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.80
|
| Rate for Payer: EPIC Health Plan Senior |
$243.80
|
| Rate for Payer: Galaxy Health WC |
$518.08
|
| Rate for Payer: Global Benefits Group Commercial |
$365.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$387.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Multiplan Commercial |
$487.60
|
| Rate for Payer: Networks By Design Commercial |
$304.75
|
| Rate for Payer: Prime Health Services Commercial |
$518.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.75
|
| Rate for Payer: United Healthcare All Other HMO |
$222.65
|
| Rate for Payer: United Healthcare HMO Rider |
$217.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.61
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
OP
|
$609.50
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.90 |
| Max. Negotiated Rate |
$518.08 |
| Rate for Payer: Adventist Health Commercial |
$121.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$518.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$368.93
|
| Rate for Payer: Blue Shield of California Commercial |
$309.02
|
| Rate for Payer: Blue Shield of California Commercial |
$468.71
|
| Rate for Payer: Cash Price |
$274.28
|
| Rate for Payer: Cigna of CA HMO |
$426.65
|
| Rate for Payer: Cigna of CA PPO |
$426.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$518.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$518.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$518.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$426.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.80
|
| Rate for Payer: EPIC Health Plan Senior |
$243.80
|
| Rate for Payer: Galaxy Health WC |
$518.08
|
| Rate for Payer: Global Benefits Group Commercial |
$365.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$387.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$221.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$426.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$426.65
|
| Rate for Payer: Multiplan Commercial |
$487.60
|
| Rate for Payer: Networks By Design Commercial |
$304.75
|
| Rate for Payer: Prime Health Services Commercial |
$518.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$365.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$365.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.75
|
| Rate for Payer: United Healthcare All Other HMO |
$222.65
|
| Rate for Payer: United Healthcare HMO Rider |
$217.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$518.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$518.08
|
| Rate for Payer: Vantage Medical Group Senior |
$518.08
|
|
|
HC CATH PMO LICOX
|
Facility
|
IP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,209.72 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Cash Price |
$1,699.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,643.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,397.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,227.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$906.27
|
| Rate for Payer: Multiplan Commercial |
$3,020.91
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
|
