|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
|
IP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$380.99
|
| Rate for Payer: Cash Price |
$380.99
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.08
|
| Rate for Payer: EPIC Health Plan Senior |
$277.08
|
| Rate for Payer: Galaxy Health WC |
$588.80
|
| Rate for Payer: Global Benefits Group Commercial |
$415.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$428.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.25
|
| Rate for Payer: Multiplan Commercial |
$554.17
|
| Rate for Payer: Networks By Design Commercial |
$346.36
|
| Rate for Payer: Prime Health Services Commercial |
$588.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.97
|
| Rate for Payer: United Healthcare All Other HMO |
$253.05
|
| Rate for Payer: United Healthcare HMO Rider |
$247.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.86
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$596.23 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$406.28
|
| Rate for Payer: Blue Shield of California Commercial |
$517.67
|
| Rate for Payer: Blue Shield of California EPN |
$340.90
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$561.16
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.35
|
| Rate for Payer: Multiplan Commercial |
$561.16
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$596.23 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$406.28
|
| Rate for Payer: Blue Shield of California Commercial |
$517.67
|
| Rate for Payer: Blue Shield of California EPN |
$340.90
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$561.16
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.35
|
| Rate for Payer: Multiplan Commercial |
$561.16
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO NGRA 12FR 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: 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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH HEMO NGRA 12FR 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CATH HEMO NGRA DL 12FR20C
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: 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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH HEMO NGRA DL 12FR20C
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CATH HEMO NGRA DL 12FR24C
|
Facility
|
OP
|
$830.30
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$544.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$705.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$622.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$509.89
|
| Rate for Payer: Cash Price |
$456.66
|
| Rate for Payer: Cigna of CA HMO |
$531.39
|
| Rate for Payer: Cigna of CA PPO |
$614.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$705.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$705.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$705.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.12
|
| Rate for Payer: EPIC Health Plan Senior |
$332.12
|
| Rate for Payer: Galaxy Health WC |
$705.75
|
| Rate for Payer: Global Benefits Group Commercial |
$498.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$581.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$581.21
|
| Rate for Payer: Multiplan Commercial |
$664.24
|
| Rate for Payer: Networks By Design Commercial |
$539.70
|
| Rate for Payer: Prime Health Services Commercial |
$705.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$415.15
|
| Rate for Payer: United Healthcare All Other HMO |
$415.15
|
| Rate for Payer: United Healthcare HMO Rider |
$415.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$415.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$705.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$705.75
|
| Rate for Payer: Vantage Medical Group Senior |
$705.75
|
|
|
HC KIT CATH HEMO NGRA DL 12FR24C
|
Facility
|
IP
|
$830.30
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Cash Price |
$456.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.12
|
| Rate for Payer: EPIC Health Plan Senior |
$332.12
|
| Rate for Payer: Galaxy Health WC |
$705.75
|
| Rate for Payer: Global Benefits Group Commercial |
$498.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.27
|
| Rate for Payer: Multiplan Commercial |
$664.24
|
| Rate for Payer: Networks By Design Commercial |
$539.70
|
| Rate for Payer: Prime Health Services Commercial |
$705.75
|
|
|
HC KIT CATH HICKMAN RPR 10FR
|
Facility
|
OP
|
$1,384.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.92 |
| Max. Negotiated Rate |
$1,176.91 |
| Rate for Payer: Adventist Health Commercial |
$276.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$761.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,038.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$801.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1,021.83
|
| Rate for Payer: Blue Shield of California EPN |
$672.92
|
| Rate for Payer: Cash Price |
$761.53
|
| Rate for Payer: Cigna of CA HMO |
$969.22
|
| Rate for Payer: Cigna of CA PPO |
$969.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,176.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,176.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.84
|
| Rate for Payer: EPIC Health Plan Senior |
$553.84
|
| Rate for Payer: Galaxy Health WC |
$1,176.91
|
| Rate for Payer: Global Benefits Group Commercial |
$830.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$527.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$857.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$969.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$969.22
|
| Rate for Payer: Multiplan Commercial |
$1,107.68
|
| Rate for Payer: Networks By Design Commercial |
$692.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$830.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$830.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$519.64
|
| Rate for Payer: United Healthcare All Other HMO |
$505.79
|
| Rate for Payer: United Healthcare HMO Rider |
$494.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$453.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,176.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,176.91
|
|
|
HC KIT CATH HICKMAN RPR 10FR
|
Facility
|
IP
|
$1,384.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.92 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$276.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$761.53
|
| Rate for Payer: Cash Price |
$761.53
|
| Rate for Payer: Cigna of CA HMO |
$969.22
|
| Rate for Payer: Cigna of CA PPO |
$969.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.84
|
| Rate for Payer: EPIC Health Plan Senior |
$553.84
|
| Rate for Payer: Galaxy Health WC |
$1,176.91
|
| Rate for Payer: Global Benefits Group Commercial |
$830.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$527.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$857.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.30
|
| Rate for Payer: Multiplan Commercial |
$1,107.68
|
| Rate for Payer: Networks By Design Commercial |
$692.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$519.64
|
| Rate for Payer: United Healthcare All Other HMO |
$505.79
|
| Rate for Payer: United Healthcare HMO Rider |
$494.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$453.46
|
|
|
HC KIT CATH HICKMAN RPR 12FR
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,697.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,117.80
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC KIT CATH HICKMAN RPR 12FR
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC KIT CATH HMDYLYS 7FR SHORT TM
|
Facility
|
OP
|
$402.29
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.46 |
| Max. Negotiated Rate |
$341.95 |
| Rate for Payer: Adventist Health Commercial |
$80.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$341.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$221.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$301.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.01
|
| Rate for Payer: Blue Shield of California Commercial |
$296.89
|
| Rate for Payer: Blue Shield of California EPN |
$195.51
|
| Rate for Payer: Cash Price |
$221.26
|
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| Rate for Payer: Cigna of CA PPO |
$281.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$341.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$341.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$341.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.92
|
| Rate for Payer: EPIC Health Plan Senior |
$160.92
|
| Rate for Payer: Galaxy Health WC |
$341.95
|
| Rate for Payer: Global Benefits Group Commercial |
$241.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$268.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$249.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$281.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$281.60
|
| Rate for Payer: Multiplan Commercial |
$321.83
|
| Rate for Payer: Networks By Design Commercial |
$201.15
|
| Rate for Payer: Prime Health Services Commercial |
$341.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.98
|
| Rate for Payer: United Healthcare All Other HMO |
$146.96
|
| Rate for Payer: United Healthcare HMO Rider |
$143.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$341.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$341.95
|
| Rate for Payer: Vantage Medical Group Senior |
$341.95
|
|
|
HC KIT CATH HMDYLYS 7FR SHORT TM
|
Facility
|
IP
|
$402.29
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$80.46 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$80.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$221.26
|
| Rate for Payer: Cash Price |
$221.26
|
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| Rate for Payer: Cigna of CA PPO |
$281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.92
|
| Rate for Payer: EPIC Health Plan Senior |
$160.92
|
| Rate for Payer: Galaxy Health WC |
$341.95
|
| Rate for Payer: Global Benefits Group Commercial |
$241.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$268.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$249.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.55
|
| Rate for Payer: Multiplan Commercial |
$321.83
|
| Rate for Payer: Networks By Design Commercial |
$201.15
|
| Rate for Payer: Prime Health Services Commercial |
$341.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.98
|
| Rate for Payer: United Healthcare All Other HMO |
$146.96
|
| Rate for Payer: United Healthcare HMO Rider |
$143.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.75
|
|
|
HC KIT CATH ICP 4FR LICOX
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901695701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC KIT CATH ICP 4FR LICOX
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901695701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,412.43
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC KIT CATH ICP 4FR LICOX+IT2
|
Facility
|
IP
|
$2,910.18
|
|
| Hospital Charge Code |
901695702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$582.04 |
| Max. Negotiated Rate |
$2,473.65 |
| Rate for Payer: Adventist Health Commercial |
$582.04
|
| Rate for Payer: Cash Price |
$1,600.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,164.07
|
| Rate for Payer: EPIC Health Plan Senior |
$1,164.07
|
| Rate for Payer: Galaxy Health WC |
$2,473.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,941.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,108.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,801.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.44
|
| Rate for Payer: Multiplan Commercial |
$2,328.14
|
| Rate for Payer: Networks By Design Commercial |
$1,891.62
|
| Rate for Payer: Prime Health Services Commercial |
$2,473.65
|
|
|
HC KIT CATH ICP 4FR LICOX+IT2
|
Facility
|
OP
|
$2,910.18
|
|
| Hospital Charge Code |
901695702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$582.04 |
| Max. Negotiated Rate |
$2,473.65 |
| Rate for Payer: Adventist Health Commercial |
$582.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,908.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,473.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,600.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,182.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,787.14
|
| Rate for Payer: Cash Price |
$1,600.60
|
| Rate for Payer: Cigna of CA HMO |
$1,862.52
|
| Rate for Payer: Cigna of CA PPO |
$2,153.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,473.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,473.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,473.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,164.07
|
| Rate for Payer: EPIC Health Plan Senior |
$1,164.07
|
| Rate for Payer: Galaxy Health WC |
$2,473.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,941.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,108.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,801.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,037.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,037.13
|
| Rate for Payer: Multiplan Commercial |
$2,328.14
|
| Rate for Payer: Networks By Design Commercial |
$1,891.62
|
| Rate for Payer: Prime Health Services Commercial |
$2,473.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,746.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,746.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,455.09
|
| Rate for Payer: United Healthcare All Other HMO |
$1,455.09
|
| Rate for Payer: United Healthcare HMO Rider |
$1,455.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,455.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,473.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,473.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,473.65
|
|
|
HC KIT CATH ICP CAMINO 4FR
|
Facility
|
OP
|
$2,610.00
|
|
| Hospital Charge Code |
901602360
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,218.50 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,711.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,602.80
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$994.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$626.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,827.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$2,088.00
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC KIT CATH ICP CAMINO 4FR
|
Facility
|
IP
|
$2,610.00
|
|
| Hospital Charge Code |
901602360
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,218.50 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$994.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$626.40
|
| Rate for Payer: Multiplan Commercial |
$2,088.00
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC KIT CATH INTRAAORTIC 8FR 30CC
|
Facility
|
IP
|
$3,373.50
|
|
| Hospital Charge Code |
901605517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$674.70 |
| Max. Negotiated Rate |
$2,867.47 |
| Rate for Payer: Adventist Health Commercial |
$674.70
|
| Rate for Payer: Cash Price |
$1,855.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,349.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,349.40
|
| Rate for Payer: Galaxy Health WC |
$2,867.47
|
| Rate for Payer: Global Benefits Group Commercial |
$2,024.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,250.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,285.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,088.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$809.64
|
| Rate for Payer: Multiplan Commercial |
$2,698.80
|
| Rate for Payer: Networks By Design Commercial |
$2,192.78
|
| Rate for Payer: Prime Health Services Commercial |
$2,867.47
|
|
|
HC KIT CATH INTRAAORTIC 8FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901605379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
