|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$302.17
|
| Rate for Payer: Blue Shield of California Commercial |
$441.90
|
| Rate for Payer: Blue Shield of California EPN |
$277.70
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$200.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$385.70
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Riverside University Health System MISP |
$220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Adventist Health Commercial |
$110.20
|
| Rate for Payer: Blue Shield of California Commercial |
$441.90
|
| Rate for Payer: Blue Shield of California EPN |
$277.70
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Senior |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$349.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.79
|
| Rate for Payer: United Healthcare All Other HMO |
$201.28
|
| Rate for Payer: United Healthcare HMO Rider |
$196.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.45
|
|
|
HC CATH PICC 5.5FR DL 55CM STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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 PICC 5.5FR DL 55CM STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
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 PICC 5FR DL 55CM W/STYLET
|
Facility
|
IP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$1,920.96 |
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,711.79
|
| Rate for Payer: Blue Shield of California EPN |
$1,075.74
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Central Health Plan Commercial |
$1,707.52
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,494.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,920.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$426.88
|
| Rate for Payer: Multiplan Commercial |
$1,600.80
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
|
|
HC CATH PICC 5FR DL 55CM W/STYLET
|
Facility
|
OP
|
$2,134.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.88 |
| Max. Negotiated Rate |
$1,920.96 |
| Rate for Payer: Adventist Health Commercial |
$426.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,173.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,600.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$974.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,170.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,711.79
|
| Rate for Payer: Blue Shield of California EPN |
$1,075.74
|
| Rate for Payer: Cash Price |
$960.48
|
| Rate for Payer: Central Health Plan Commercial |
$1,707.52
|
| Rate for Payer: Cigna of CA HMO |
$1,494.08
|
| Rate for Payer: Cigna of CA PPO |
$1,494.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,814.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,814.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,494.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.76
|
| Rate for Payer: EPIC Health Plan Senior |
$853.76
|
| Rate for Payer: Galaxy Health WC |
$1,814.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,920.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$774.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$426.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,494.08
|
| Rate for Payer: Multiplan Commercial |
$1,600.80
|
| Rate for Payer: Networks By Design Commercial |
$1,067.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,814.24
|
| Rate for Payer: Riverside University Health System MISP |
$853.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,280.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,280.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$801.04
|
| Rate for Payer: United Healthcare All Other HMO |
$779.70
|
| Rate for Payer: United Healthcare HMO Rider |
$762.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$699.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,814.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,814.24
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$1,499.59 |
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$916.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,249.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$760.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$913.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,336.30
|
| Rate for Payer: Blue Shield of California EPN |
$839.77
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.97
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,416.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,416.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,166.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,058.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$604.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,166.35
|
| Rate for Payer: Multiplan Commercial |
$1,249.66
|
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: Riverside University Health System MISP |
$666.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$999.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$999.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,416.28
|
| Rate for Payer: Vantage Medical Group Senior |
$1,416.28
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$1,666.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$333.24 |
| Max. Negotiated Rate |
$1,499.59 |
| Rate for Payer: Adventist Health Commercial |
$333.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,336.30
|
| Rate for Payer: Blue Shield of California EPN |
$839.77
|
| Rate for Payer: Cash Price |
$749.79
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.97
|
| Rate for Payer: Cigna of CA HMO |
$1,166.35
|
| Rate for Payer: Cigna of CA PPO |
$1,166.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,166.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.48
|
| Rate for Payer: EPIC Health Plan Senior |
$666.48
|
| Rate for Payer: Galaxy Health WC |
$1,416.28
|
| Rate for Payer: Global Benefits Group Commercial |
$999.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,058.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.24
|
| Rate for Payer: Multiplan Commercial |
$1,249.66
|
| Rate for Payer: Networks By Design Commercial |
$833.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$625.33
|
| Rate for Payer: United Healthcare All Other HMO |
$608.67
|
| Rate for Payer: United Healthcare HMO Rider |
$595.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.68
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC INS TRAY NEONATAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC INS TRAY NEONATAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
OP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$852.01 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$520.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$710.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$432.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$519.16
|
| Rate for Payer: Blue Shield of California Commercial |
$759.24
|
| Rate for Payer: Blue Shield of California EPN |
$477.13
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Central Health Plan Commercial |
$757.34
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$804.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$804.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$804.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$852.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$601.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$343.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$558.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$662.68
|
| Rate for Payer: Multiplan Commercial |
$710.01
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: Riverside University Health System MISP |
$378.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$568.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$568.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$804.68
|
| Rate for Payer: Vantage Medical Group Senior |
$804.68
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
IP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$852.01 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Blue Shield of California Commercial |
$759.24
|
| Rate for Payer: Blue Shield of California EPN |
$477.13
|
| Rate for Payer: Cash Price |
$426.01
|
| Rate for Payer: Central Health Plan Commercial |
$757.34
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$852.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$601.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$558.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.34
|
| Rate for Payer: Multiplan Commercial |
$710.01
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
OP
|
$1,658.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.62 |
| Max. Negotiated Rate |
$1,492.31 |
| Rate for Payer: Adventist Health Commercial |
$331.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$911.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,243.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$757.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$909.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1,329.81
|
| Rate for Payer: Blue Shield of California EPN |
$835.69
|
| Rate for Payer: Cash Price |
$746.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,326.50
|
| Rate for Payer: Cigna of CA HMO |
$1,160.68
|
| Rate for Payer: Cigna of CA PPO |
$1,160.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,409.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,409.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,160.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$663.25
|
| Rate for Payer: EPIC Health Plan Senior |
$663.25
|
| Rate for Payer: Galaxy Health WC |
$1,409.40
|
| Rate for Payer: Global Benefits Group Commercial |
$994.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,492.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,052.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$601.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$978.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,160.68
|
| Rate for Payer: Multiplan Commercial |
$1,243.59
|
| Rate for Payer: Networks By Design Commercial |
$829.06
|
| Rate for Payer: Prime Health Services Commercial |
$1,409.40
|
| Rate for Payer: Riverside University Health System MISP |
$663.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$994.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$994.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$622.29
|
| Rate for Payer: United Healthcare All Other HMO |
$605.71
|
| Rate for Payer: United Healthcare HMO Rider |
$592.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$543.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,409.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,409.40
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
IP
|
$1,658.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.62 |
| Max. Negotiated Rate |
$1,492.31 |
| Rate for Payer: Adventist Health Commercial |
$331.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,329.81
|
| Rate for Payer: Blue Shield of California EPN |
$835.69
|
| Rate for Payer: Cash Price |
$746.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,326.50
|
| Rate for Payer: Cigna of CA HMO |
$1,160.68
|
| Rate for Payer: Cigna of CA PPO |
$1,160.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,160.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$663.25
|
| Rate for Payer: EPIC Health Plan Senior |
$663.25
|
| Rate for Payer: Galaxy Health WC |
$1,409.40
|
| Rate for Payer: Global Benefits Group Commercial |
$994.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,492.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,052.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$978.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.62
|
| Rate for Payer: Multiplan Commercial |
$1,243.59
|
| Rate for Payer: Networks By Design Commercial |
$829.06
|
| Rate for Payer: Prime Health Services Commercial |
$1,409.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$622.29
|
| Rate for Payer: United Healthcare All Other HMO |
$605.71
|
| Rate for Payer: United Healthcare HMO Rider |
$592.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$543.03
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
IP
|
$386.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Adventist Health Commercial |
$77.22
|
| Rate for Payer: Blue Shield of California Commercial |
$309.66
|
| Rate for Payer: Blue Shield of California EPN |
$194.60
|
| Rate for Payer: Cash Price |
$173.75
|
| Rate for Payer: Central Health Plan Commercial |
$308.89
|
| Rate for Payer: Cigna of CA HMO |
$270.28
|
| Rate for Payer: Cigna of CA PPO |
$270.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.44
|
| Rate for Payer: EPIC Health Plan Senior |
$154.44
|
| Rate for Payer: Galaxy Health WC |
$328.19
|
| Rate for Payer: Global Benefits Group Commercial |
$231.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$347.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.22
|
| Rate for Payer: Multiplan Commercial |
$289.58
|
| Rate for Payer: Networks By Design Commercial |
$193.06
|
| Rate for Payer: Prime Health Services Commercial |
$328.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.91
|
| Rate for Payer: United Healthcare All Other HMO |
$141.05
|
| Rate for Payer: United Healthcare HMO Rider |
$138.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.45
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
OP
|
$386.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Adventist Health Commercial |
$77.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$289.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$176.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$211.74
|
| Rate for Payer: Blue Shield of California Commercial |
$309.66
|
| Rate for Payer: Blue Shield of California EPN |
$194.60
|
| Rate for Payer: Cash Price |
$173.75
|
| Rate for Payer: Central Health Plan Commercial |
$308.89
|
| Rate for Payer: Cigna of CA HMO |
$270.28
|
| Rate for Payer: Cigna of CA PPO |
$270.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$270.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.44
|
| Rate for Payer: EPIC Health Plan Senior |
$154.44
|
| Rate for Payer: Galaxy Health WC |
$328.19
|
| Rate for Payer: Global Benefits Group Commercial |
$231.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$347.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$245.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$270.28
|
| Rate for Payer: Multiplan Commercial |
$289.58
|
| Rate for Payer: Networks By Design Commercial |
$193.06
|
| Rate for Payer: Prime Health Services Commercial |
$328.19
|
| Rate for Payer: Riverside University Health System MISP |
$154.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.91
|
| Rate for Payer: United Healthcare All Other HMO |
$141.05
|
| Rate for Payer: United Healthcare HMO Rider |
$138.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.19
|
| Rate for Payer: Vantage Medical Group Senior |
$328.19
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
OP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$325.41 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$271.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$198.28
|
| Rate for Payer: Blue Shield of California Commercial |
$289.98
|
| Rate for Payer: Blue Shield of California EPN |
$182.23
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Central Health Plan Commercial |
$289.26
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$307.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$307.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$325.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$253.10
|
| Rate for Payer: Multiplan Commercial |
$271.18
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: Riverside University Health System MISP |
$144.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$216.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$216.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$307.33
|
| Rate for Payer: Vantage Medical Group Senior |
$307.33
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
IP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$325.41 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Blue Shield of California Commercial |
$289.98
|
| Rate for Payer: Blue Shield of California EPN |
$182.23
|
| Rate for Payer: Cash Price |
$162.71
|
| Rate for Payer: Central Health Plan Commercial |
$289.26
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$325.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$213.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.31
|
| Rate for Payer: Multiplan Commercial |
$271.18
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
OP
|
$393.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.69 |
| Max. Negotiated Rate |
$354.12 |
| Rate for Payer: Adventist Health Commercial |
$78.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$215.78
|
| Rate for Payer: Blue Shield of California Commercial |
$315.56
|
| Rate for Payer: Blue Shield of California EPN |
$198.31
|
| Rate for Payer: Cash Price |
$177.06
|
| Rate for Payer: Central Health Plan Commercial |
$314.78
|
| Rate for Payer: Cigna of CA HMO |
$275.43
|
| Rate for Payer: Cigna of CA PPO |
$275.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.39
|
| Rate for Payer: EPIC Health Plan Senior |
$157.39
|
| Rate for Payer: Galaxy Health WC |
$334.45
|
| Rate for Payer: Global Benefits Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$275.43
|
| Rate for Payer: Multiplan Commercial |
$295.10
|
| Rate for Payer: Networks By Design Commercial |
$196.74
|
| Rate for Payer: Prime Health Services Commercial |
$334.45
|
| Rate for Payer: Riverside University Health System MISP |
$157.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.67
|
| Rate for Payer: United Healthcare All Other HMO |
$143.73
|
| Rate for Payer: United Healthcare HMO Rider |
$140.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.45
|
| Rate for Payer: Vantage Medical Group Senior |
$334.45
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
IP
|
$393.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.69 |
| Max. Negotiated Rate |
$354.12 |
| Rate for Payer: Adventist Health Commercial |
$78.69
|
| Rate for Payer: Blue Shield of California Commercial |
$315.56
|
| Rate for Payer: Blue Shield of California EPN |
$198.31
|
| Rate for Payer: Cash Price |
$177.06
|
| Rate for Payer: Central Health Plan Commercial |
$314.78
|
| Rate for Payer: Cigna of CA HMO |
$275.43
|
| Rate for Payer: Cigna of CA PPO |
$275.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.39
|
| Rate for Payer: EPIC Health Plan Senior |
$157.39
|
| Rate for Payer: Galaxy Health WC |
$334.45
|
| Rate for Payer: Global Benefits Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.69
|
| Rate for Payer: Multiplan Commercial |
$295.10
|
| Rate for Payer: Networks By Design Commercial |
$196.74
|
| Rate for Payer: Prime Health Services Commercial |
$334.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.67
|
| Rate for Payer: United Healthcare All Other HMO |
$143.73
|
| Rate for Payer: United Healthcare HMO Rider |
$140.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.86
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Blue Shield of California Commercial |
$937.06
|
| Rate for Payer: Blue Shield of California EPN |
$588.87
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$741.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$689.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
|
