|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
OP
|
$8.28
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$7.45 |
| Rate for Payer: Adventist Health Commercial |
$1.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.82
|
| Rate for Payer: Blue Shield of California Commercial |
$5.25
|
| Rate for Payer: Blue Shield of California EPN |
$3.30
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Central Health Plan Commercial |
$6.62
|
| Rate for Payer: Cigna of CA HMO |
$5.30
|
| Rate for Payer: Cigna of CA PPO |
$6.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.31
|
| Rate for Payer: Galaxy Health WC |
$7.04
|
| Rate for Payer: Global Benefits Group Commercial |
$4.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.80
|
| Rate for Payer: Multiplan Commercial |
$6.21
|
| Rate for Payer: Networks By Design Commercial |
$5.38
|
| Rate for Payer: Prime Health Services Commercial |
$7.04
|
| Rate for Payer: Riverside University Health System MISP |
$3.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.14
|
| Rate for Payer: United Healthcare All Other HMO |
$4.14
|
| Rate for Payer: United Healthcare HMO Rider |
$4.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.04
|
| Rate for Payer: Vantage Medical Group Senior |
$7.04
|
|
|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
IP
|
$8.28
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$7.45 |
| Rate for Payer: Adventist Health Commercial |
$1.66
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Central Health Plan Commercial |
$6.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.31
|
| Rate for Payer: Galaxy Health WC |
$7.04
|
| Rate for Payer: Global Benefits Group Commercial |
$4.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.66
|
| Rate for Payer: Multiplan Commercial |
$6.21
|
| Rate for Payer: Networks By Design Commercial |
$5.38
|
| Rate for Payer: Prime Health Services Commercial |
$7.04
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
IP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
OP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Adventist Health Commercial |
$1.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.44
|
| Rate for Payer: Blue Shield of California Commercial |
$4.84
|
| Rate for Payer: Blue Shield of California EPN |
$3.04
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: Cigna of CA HMO |
$4.88
|
| Rate for Payer: Cigna of CA PPO |
$5.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.34
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
| Rate for Payer: Riverside University Health System MISP |
$3.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.81
|
| Rate for Payer: United Healthcare All Other HMO |
$3.81
|
| Rate for Payer: United Healthcare HMO Rider |
$3.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.49
|
| Rate for Payer: Vantage Medical Group Senior |
$6.49
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$144.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.35
|
| Rate for Payer: Blue Shield of California Commercial |
$188.93
|
| Rate for Payer: Blue Shield of California EPN |
$118.90
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$108.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Riverside University Health System MISP |
$119.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$208.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH MED NIH
|
Facility
|
IP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$371.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$337.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$313.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC CATH MED NIH
|
Facility
|
OP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$322.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$398.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$257.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$308.88
|
| Rate for Payer: Blue Shield of California Commercial |
$336.65
|
| Rate for Payer: Blue Shield of California EPN |
$211.87
|
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$451.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$371.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$337.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$313.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$371.70
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Riverside University Health System MISP |
$212.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$265.50
|
| Rate for Payer: United Healthcare All Other HMO |
$265.50
|
| Rate for Payer: United Healthcare HMO Rider |
$265.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
|
HC CATH MERIT MOD V
|
Facility
|
OP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.68
|
| Rate for Payer: Blue Shield of California Commercial |
$65.05
|
| Rate for Payer: Blue Shield of California EPN |
$40.94
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: Cigna of CA HMO |
$65.66
|
| Rate for Payer: Cigna of CA PPO |
$75.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$71.82
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
| Rate for Payer: Riverside University Health System MISP |
$41.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.30
|
| Rate for Payer: United Healthcare All Other HMO |
$51.30
|
| Rate for Payer: United Healthcare HMO Rider |
$51.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.21
|
| Rate for Payer: Vantage Medical Group Senior |
$87.21
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
OP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$62.06 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.11
|
| Rate for Payer: Blue Shield of California Commercial |
$43.72
|
| Rate for Payer: Blue Shield of California EPN |
$27.52
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: Central Health Plan Commercial |
$55.17
|
| Rate for Payer: Cigna of CA HMO |
$44.13
|
| Rate for Payer: Cigna of CA PPO |
$51.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$48.27
|
| Rate for Payer: Multiplan Commercial |
$51.72
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
| Rate for Payer: Riverside University Health System MISP |
$27.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.48
|
| Rate for Payer: United Healthcare All Other HMO |
$34.48
|
| Rate for Payer: United Healthcare HMO Rider |
$34.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.62
|
| Rate for Payer: Vantage Medical Group Senior |
$58.62
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
IP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$62.06 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Cash Price |
$31.03
|
| Rate for Payer: Central Health Plan Commercial |
$55.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.79
|
| Rate for Payer: Multiplan Commercial |
$51.72
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| 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: Health Management Network EPO/PPO |
$522.00
|
| 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 |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| 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 Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| 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: Health Management Network EPO/PPO |
$522.00
|
| 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 |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
OP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.91 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$485.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$583.69
|
| Rate for Payer: Blue Shield of California Commercial |
$853.61
|
| Rate for Payer: Blue Shield of California EPN |
$536.43
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$904.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$904.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$904.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$675.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$386.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$627.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$745.04
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: Riverside University Health System MISP |
$425.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$638.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$638.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$904.70
|
| Rate for Payer: Vantage Medical Group Senior |
$904.70
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
IP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.91 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Blue Shield of California Commercial |
$853.61
|
| Rate for Payer: Blue Shield of California EPN |
$536.43
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$675.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$627.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
OP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$545.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$332.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$398.75
|
| Rate for Payer: Blue Shield of California Commercial |
$583.15
|
| Rate for Payer: Blue Shield of California EPN |
$366.47
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$618.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$618.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$618.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$461.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$263.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$508.98
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: Riverside University Health System MISP |
$290.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$436.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$618.05
|
| Rate for Payer: Vantage Medical Group Senior |
$618.05
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
IP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Blue Shield of California Commercial |
$583.15
|
| Rate for Payer: Blue Shield of California EPN |
$366.47
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$461.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
|
|
HC CATH MIDLINE 4FR SL CDC KIT
|
Facility
|
OP
|
$770.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.19 |
| Max. Negotiated Rate |
$693.86 |
| Rate for Payer: Adventist Health Commercial |
$154.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$655.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$424.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$578.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$352.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$422.79
|
| Rate for Payer: Blue Shield of California Commercial |
$618.31
|
| Rate for Payer: Blue Shield of California EPN |
$388.56
|
| Rate for Payer: Cash Price |
$346.93
|
| Rate for Payer: Central Health Plan Commercial |
$616.77
|
| Rate for Payer: Cigna of CA HMO |
$539.67
|
| Rate for Payer: Cigna of CA PPO |
$539.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$655.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$655.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$655.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$539.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$308.38
|
| Rate for Payer: EPIC Health Plan Senior |
$308.38
|
| Rate for Payer: Galaxy Health WC |
$655.32
|
| Rate for Payer: Global Benefits Group Commercial |
$462.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$693.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$489.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$279.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$454.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$539.67
|
| Rate for Payer: Multiplan Commercial |
$578.22
|
| Rate for Payer: Networks By Design Commercial |
$385.48
|
| Rate for Payer: Prime Health Services Commercial |
$655.32
|
| Rate for Payer: Riverside University Health System MISP |
$308.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$462.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$462.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.34
|
| Rate for Payer: United Healthcare All Other HMO |
$281.63
|
| Rate for Payer: United Healthcare HMO Rider |
$275.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$252.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$655.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$655.32
|
| Rate for Payer: Vantage Medical Group Senior |
$655.32
|
|
|
HC CATH MIDLINE 4FR SL CDC KIT
|
Facility
|
IP
|
$770.96
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.19 |
| Max. Negotiated Rate |
$693.86 |
| Rate for Payer: Adventist Health Commercial |
$154.19
|
| Rate for Payer: Blue Shield of California Commercial |
$618.31
|
| Rate for Payer: Blue Shield of California EPN |
$388.56
|
| Rate for Payer: Cash Price |
$346.93
|
| Rate for Payer: Central Health Plan Commercial |
$616.77
|
| Rate for Payer: Cigna of CA HMO |
$539.67
|
| Rate for Payer: Cigna of CA PPO |
$539.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$539.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$308.38
|
| Rate for Payer: EPIC Health Plan Senior |
$308.38
|
| Rate for Payer: Galaxy Health WC |
$655.32
|
| Rate for Payer: Global Benefits Group Commercial |
$462.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$693.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$489.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$454.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.19
|
| Rate for Payer: Multiplan Commercial |
$578.22
|
| Rate for Payer: Networks By Design Commercial |
$385.48
|
| Rate for Payer: Prime Health Services Commercial |
$655.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$289.34
|
| Rate for Payer: United Healthcare All Other HMO |
$281.63
|
| Rate for Payer: United Healthcare HMO Rider |
$275.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$252.49
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
IP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Blue Shield of California Commercial |
$620.30
|
| Rate for Payer: Blue Shield of California EPN |
$389.81
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
OP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$353.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$424.15
|
| Rate for Payer: Blue Shield of California Commercial |
$620.30
|
| Rate for Payer: Blue Shield of California EPN |
$389.81
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$541.41
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: Riverside University Health System MISP |
$309.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.42
|
| Rate for Payer: Vantage Medical Group Senior |
$657.42
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
IP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Blue Shield of California Commercial |
$634.54
|
| Rate for Payer: Blue Shield of California EPN |
$398.76
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
OP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$361.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$433.89
|
| Rate for Payer: Blue Shield of California Commercial |
$634.54
|
| Rate for Payer: Blue Shield of California EPN |
$398.76
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$287.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$466.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Riverside University Health System MISP |
$316.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
IP
|
$829.89
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.98 |
| Max. Negotiated Rate |
$746.90 |
| Rate for Payer: Adventist Health Commercial |
$165.98
|
| Rate for Payer: Blue Shield of California Commercial |
$665.57
|
| Rate for Payer: Blue Shield of California EPN |
$418.26
|
| Rate for Payer: Cash Price |
$373.45
|
| Rate for Payer: Central Health Plan Commercial |
$663.91
|
| Rate for Payer: Cigna of CA HMO |
$580.92
|
| Rate for Payer: Cigna of CA PPO |
$580.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$580.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.96
|
| Rate for Payer: EPIC Health Plan Senior |
$331.96
|
| Rate for Payer: Galaxy Health WC |
$705.41
|
| Rate for Payer: Global Benefits Group Commercial |
$497.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$526.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$489.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.98
|
| Rate for Payer: Multiplan Commercial |
$622.42
|
| Rate for Payer: Networks By Design Commercial |
$414.94
|
| Rate for Payer: Prime Health Services Commercial |
$705.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$311.46
|
| Rate for Payer: United Healthcare All Other HMO |
$303.16
|
| Rate for Payer: United Healthcare HMO Rider |
$296.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.79
|
|
