|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
|
OP
|
$841.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.31 |
| Max. Negotiated Rate |
$715.33 |
| Rate for Payer: Adventist Health Commercial |
$168.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$715.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$462.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$631.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$509.40
|
| Rate for Payer: Blue Shield of California Commercial |
$426.68
|
| Rate for Payer: Blue Shield of California Commercial |
$647.17
|
| Rate for Payer: Cash Price |
$378.71
|
| Rate for Payer: Cigna of CA HMO |
$589.10
|
| Rate for Payer: Cigna of CA PPO |
$589.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$715.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$715.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$715.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$589.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.63
|
| Rate for Payer: EPIC Health Plan Senior |
$336.63
|
| Rate for Payer: Galaxy Health WC |
$715.33
|
| Rate for Payer: Global Benefits Group Commercial |
$504.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$534.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$496.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$589.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$589.10
|
| Rate for Payer: Multiplan Commercial |
$673.26
|
| Rate for Payer: Networks By Design Commercial |
$420.79
|
| Rate for Payer: Prime Health Services Commercial |
$715.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$504.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$504.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.84
|
| Rate for Payer: United Healthcare All Other HMO |
$307.43
|
| Rate for Payer: United Healthcare HMO Rider |
$300.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$715.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$715.33
|
| Rate for Payer: Vantage Medical Group Senior |
$715.33
|
|
|
HC KIT CATH CNTRL VNS 5FR DL
|
Facility
|
OP
|
$722.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$613.75 |
| Rate for Payer: Adventist Health Commercial |
$144.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$613.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$397.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$437.06
|
| Rate for Payer: Blue Shield of California Commercial |
$366.08
|
| Rate for Payer: Blue Shield of California Commercial |
$555.26
|
| Rate for Payer: Cash Price |
$324.93
|
| Rate for Payer: Cigna of CA HMO |
$505.44
|
| Rate for Payer: Cigna of CA PPO |
$505.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$613.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$613.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$613.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$505.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.82
|
| Rate for Payer: EPIC Health Plan Senior |
$288.82
|
| Rate for Payer: Galaxy Health WC |
$613.75
|
| Rate for Payer: Global Benefits Group Commercial |
$433.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$458.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$262.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$505.44
|
| Rate for Payer: Multiplan Commercial |
$577.65
|
| Rate for Payer: Networks By Design Commercial |
$361.03
|
| Rate for Payer: Prime Health Services Commercial |
$613.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$270.99
|
| Rate for Payer: United Healthcare All Other HMO |
$263.77
|
| Rate for Payer: United Healthcare HMO Rider |
$258.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$236.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$613.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$613.75
|
| Rate for Payer: Vantage Medical Group Senior |
$613.75
|
|
|
HC KIT CATH CNTRL VNS 5FR DL
|
Facility
|
IP
|
$722.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$144.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$324.93
|
| Rate for Payer: Cash Price |
$324.93
|
| Rate for Payer: Cigna of CA HMO |
$505.44
|
| Rate for Payer: Cigna of CA PPO |
$505.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$505.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.82
|
| Rate for Payer: EPIC Health Plan Senior |
$288.82
|
| Rate for Payer: Galaxy Health WC |
$613.75
|
| Rate for Payer: Global Benefits Group Commercial |
$433.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$458.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.29
|
| Rate for Payer: Multiplan Commercial |
$577.65
|
| Rate for Payer: Networks By Design Commercial |
$361.03
|
| Rate for Payer: Prime Health Services Commercial |
$613.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$270.99
|
| Rate for Payer: United Healthcare All Other HMO |
$263.77
|
| Rate for Payer: United Healthcare HMO Rider |
$258.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$236.47
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$863.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.69 |
| Max. Negotiated Rate |
$733.95 |
| Rate for Payer: Adventist Health Commercial |
$172.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$733.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$474.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.66
|
| Rate for Payer: Blue Shield of California Commercial |
$437.78
|
| Rate for Payer: Blue Shield of California Commercial |
$664.01
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cigna of CA HMO |
$604.43
|
| Rate for Payer: Cigna of CA PPO |
$604.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$733.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$733.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$733.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.39
|
| Rate for Payer: EPIC Health Plan Senior |
$345.39
|
| Rate for Payer: Galaxy Health WC |
$733.95
|
| Rate for Payer: Global Benefits Group Commercial |
$518.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$509.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$604.43
|
| Rate for Payer: Multiplan Commercial |
$690.78
|
| Rate for Payer: Networks By Design Commercial |
$431.74
|
| Rate for Payer: Prime Health Services Commercial |
$733.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$518.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$518.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$324.06
|
| Rate for Payer: United Healthcare All Other HMO |
$315.43
|
| Rate for Payer: United Healthcare HMO Rider |
$308.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$733.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$733.95
|
| Rate for Payer: Vantage Medical Group Senior |
$733.95
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$863.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$172.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cigna of CA HMO |
$604.43
|
| Rate for Payer: Cigna of CA PPO |
$604.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.39
|
| Rate for Payer: EPIC Health Plan Senior |
$345.39
|
| Rate for Payer: Galaxy Health WC |
$733.95
|
| Rate for Payer: Global Benefits Group Commercial |
$518.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$509.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.23
|
| Rate for Payer: Multiplan Commercial |
$690.78
|
| Rate for Payer: Networks By Design Commercial |
$431.74
|
| Rate for Payer: Prime Health Services Commercial |
$733.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$324.06
|
| Rate for Payer: United Healthcare All Other HMO |
$315.43
|
| Rate for Payer: United Healthcare HMO Rider |
$308.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.79
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$863.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.69 |
| Max. Negotiated Rate |
$733.95 |
| Rate for Payer: Adventist Health Commercial |
$172.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$733.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$474.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.66
|
| Rate for Payer: Blue Shield of California Commercial |
$437.78
|
| Rate for Payer: Blue Shield of California Commercial |
$664.01
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cigna of CA HMO |
$604.43
|
| Rate for Payer: Cigna of CA PPO |
$604.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$733.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$733.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$733.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.39
|
| Rate for Payer: EPIC Health Plan Senior |
$345.39
|
| Rate for Payer: Galaxy Health WC |
$733.95
|
| Rate for Payer: Global Benefits Group Commercial |
$518.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$509.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$604.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$604.43
|
| Rate for Payer: Multiplan Commercial |
$690.78
|
| Rate for Payer: Networks By Design Commercial |
$431.74
|
| Rate for Payer: Prime Health Services Commercial |
$733.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$518.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$518.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$324.06
|
| Rate for Payer: United Healthcare All Other HMO |
$315.43
|
| Rate for Payer: United Healthcare HMO Rider |
$308.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$733.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$733.95
|
| Rate for Payer: Vantage Medical Group Senior |
$733.95
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$863.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.69 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$172.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cash Price |
$388.56
|
| Rate for Payer: Cigna of CA HMO |
$604.43
|
| Rate for Payer: Cigna of CA PPO |
$604.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$604.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.39
|
| Rate for Payer: EPIC Health Plan Senior |
$345.39
|
| Rate for Payer: Galaxy Health WC |
$733.95
|
| Rate for Payer: Global Benefits Group Commercial |
$518.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$548.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$509.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.23
|
| Rate for Payer: Multiplan Commercial |
$690.78
|
| Rate for Payer: Networks By Design Commercial |
$431.74
|
| Rate for Payer: Prime Health Services Commercial |
$733.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$324.06
|
| Rate for Payer: United Healthcare All Other HMO |
$315.43
|
| Rate for Payer: United Healthcare HMO Rider |
$308.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.79
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
IP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$13.73 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.88
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
OP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$13.73 |
| Rate for Payer: United Healthcare HMO Rider |
$8.07
|
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.36
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Cigna of CA HMO |
$10.34
|
| Rate for Payer: Cigna of CA PPO |
$11.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.30
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.07
|
| Rate for Payer: United Healthcare All Other HMO |
$8.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$588.80 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$519.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.30
|
| Rate for Payer: Blue Shield of California Commercial |
$351.20
|
| Rate for Payer: Blue Shield of California Commercial |
$532.69
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$588.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$588.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$251.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$484.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$484.90
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$415.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.63
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$588.80
|
| Rate for Payer: Vantage Medical Group Senior |
$588.80
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| 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 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$588.80 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$519.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.30
|
| Rate for Payer: Blue Shield of California Commercial |
$351.20
|
| Rate for Payer: Blue Shield of California Commercial |
$532.69
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$588.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$588.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$251.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$484.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$484.90
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$415.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.63
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$588.80
|
| Rate for Payer: Vantage Medical Group Senior |
$588.80
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| 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 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| 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 2LUMEN 12FRX25CM
|
Facility
|
OP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$588.80 |
| Rate for Payer: Galaxy Health WC |
$588.80
|
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$519.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.30
|
| Rate for Payer: Blue Shield of California Commercial |
$351.20
|
| Rate for Payer: Blue Shield of California Commercial |
$532.69
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$588.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$588.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$484.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.08
|
| Rate for Payer: EPIC Health Plan Senior |
$277.08
|
| Rate for Payer: Global Benefits Group Commercial |
$415.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$251.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$484.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$484.90
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$415.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.63
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$588.80
|
| Rate for Payer: Vantage Medical Group Senior |
$588.80
|
|
|
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: Dignity Health Medi-Cal |
$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 |
$424.59
|
| Rate for Payer: Blue Shield of California Commercial |
$355.64
|
| Rate for Payer: Blue Shield of California Commercial |
$539.42
|
| Rate for Payer: Cash Price |
$315.65
|
| 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 Medicare Advantage |
$596.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$445.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$413.86
|
| 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$445.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$413.86
|
| 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 |
$424.59
|
| Rate for Payer: Blue Shield of California Commercial |
$355.64
|
| Rate for Payer: Blue Shield of California Commercial |
$539.42
|
| Rate for Payer: Cash Price |
$315.65
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$445.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$254.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$413.86
|
| 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$445.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$413.86
|
| 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 |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$294.06
|
| Rate for Payer: Blue Shield of California Commercial |
$446.02
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC 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 |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC 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 |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$294.06
|
| Rate for Payer: Blue Shield of California Commercial |
$446.02
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC 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: Cash Price |
$373.64
|
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.21
|
| 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 Foundation Hospitals Commercial/Self Funded |
$527.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$489.88
|
| 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 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 |
$2,470.26 |
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,470.26
|
| 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 |
$532.80
|
| Rate for Payer: Cash Price |
$373.64
|
| Rate for Payer: Cash Price |
$373.64
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.21
|
| 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 Foundation Hospitals Commercial/Self Funded |
$527.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$301.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$489.88
|
| 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
|
|
