|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
IP
|
$101.54
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$91.39 |
| Rate for Payer: Adventist Health Commercial |
$20.31
|
| Rate for Payer: Cash Price |
$55.85
|
| Rate for Payer: Central Health Plan Commercial |
$81.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.62
|
| Rate for Payer: EPIC Health Plan Senior |
$40.62
|
| Rate for Payer: Galaxy Health WC |
$86.31
|
| Rate for Payer: Global Benefits Group Commercial |
$60.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.31
|
| Rate for Payer: Multiplan Commercial |
$76.16
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$86.31
|
|
|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
OP
|
$101.54
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$91.39 |
| Rate for Payer: Adventist Health Commercial |
$20.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.63
|
| Rate for Payer: Blue Shield of California Commercial |
$62.04
|
| Rate for Payer: Blue Shield of California EPN |
$40.51
|
| Rate for Payer: Cash Price |
$55.85
|
| Rate for Payer: Central Health Plan Commercial |
$81.23
|
| Rate for Payer: Cigna of CA HMO |
$64.99
|
| Rate for Payer: Cigna of CA PPO |
$75.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.62
|
| Rate for Payer: EPIC Health Plan Senior |
$40.62
|
| Rate for Payer: Galaxy Health WC |
$86.31
|
| Rate for Payer: Global Benefits Group Commercial |
$60.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.39
|
| Rate for Payer: InnovAge PACE Commercial |
$50.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.08
|
| Rate for Payer: Multiplan Commercial |
$76.16
|
| Rate for Payer: Networks By Design Commercial |
$66.00
|
| Rate for Payer: Prime Health Services Commercial |
$86.31
|
| Rate for Payer: Riverside University Health System MISP |
$40.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.77
|
| Rate for Payer: United Healthcare All Other HMO |
$50.77
|
| Rate for Payer: United Healthcare HMO Rider |
$50.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.31
|
| Rate for Payer: Vantage Medical Group Senior |
$86.31
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
IP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$521.48 |
| Rate for Payer: Adventist Health Commercial |
$115.88
|
| Rate for Payer: Blue Shield of California Commercial |
$447.89
|
| Rate for Payer: Blue Shield of California EPN |
$292.03
|
| Rate for Payer: Cash Price |
$318.68
|
| Rate for Payer: Central Health Plan Commercial |
$463.54
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Senior |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$521.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$358.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.88
|
| Rate for Payer: Multiplan Commercial |
$434.56
|
| Rate for Payer: Networks By Design Commercial |
$289.71
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.46
|
| Rate for Payer: United Healthcare All Other HMO |
$211.66
|
| Rate for Payer: United Healthcare HMO Rider |
$207.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.76
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
OP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$521.48 |
| Rate for Payer: Adventist Health Commercial |
$115.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$492.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$318.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$434.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$320.82
|
| Rate for Payer: Blue Shield of California Commercial |
$447.89
|
| Rate for Payer: Blue Shield of California EPN |
$292.03
|
| Rate for Payer: Cash Price |
$318.68
|
| Rate for Payer: Central Health Plan Commercial |
$463.54
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$492.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$492.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$492.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Senior |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$521.48
|
| Rate for Payer: InnovAge PACE Commercial |
$289.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$358.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$405.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$405.59
|
| Rate for Payer: Multiplan Commercial |
$434.56
|
| Rate for Payer: Networks By Design Commercial |
$289.71
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: Riverside University Health System MISP |
$231.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$347.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$347.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.46
|
| Rate for Payer: United Healthcare All Other HMO |
$211.66
|
| Rate for Payer: United Healthcare HMO Rider |
$207.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$492.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$492.51
|
| Rate for Payer: Vantage Medical Group Senior |
$492.51
|
|
|
HC CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| 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 |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: 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: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| 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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH CNTRL VNS 4FR
|
Facility
|
OP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$321.35 |
| Rate for Payer: Adventist Health Commercial |
$71.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$303.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$196.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$163.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.70
|
| Rate for Payer: Blue Shield of California Commercial |
$276.00
|
| Rate for Payer: Blue Shield of California EPN |
$179.95
|
| Rate for Payer: Cash Price |
$196.38
|
| Rate for Payer: Central Health Plan Commercial |
$285.64
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$303.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$303.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$303.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Senior |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$321.35
|
| Rate for Payer: InnovAge PACE Commercial |
$178.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$221.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$249.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$249.94
|
| Rate for Payer: Multiplan Commercial |
$267.79
|
| Rate for Payer: Networks By Design Commercial |
$178.53
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: Riverside University Health System MISP |
$142.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$214.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$214.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.00
|
| Rate for Payer: United Healthcare All Other HMO |
$130.43
|
| Rate for Payer: United Healthcare HMO Rider |
$127.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$303.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$303.49
|
| Rate for Payer: Vantage Medical Group Senior |
$303.49
|
|
|
HC CATH CNTRL VNS 4FR
|
Facility
|
IP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$321.35 |
| Rate for Payer: Adventist Health Commercial |
$71.41
|
| Rate for Payer: Blue Shield of California Commercial |
$276.00
|
| Rate for Payer: Blue Shield of California EPN |
$179.95
|
| Rate for Payer: Cash Price |
$196.38
|
| Rate for Payer: Central Health Plan Commercial |
$285.64
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Senior |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$321.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$221.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.41
|
| Rate for Payer: Multiplan Commercial |
$267.79
|
| Rate for Payer: Networks By Design Commercial |
$178.53
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.00
|
| Rate for Payer: United Healthcare All Other HMO |
$130.43
|
| Rate for Payer: United Healthcare HMO Rider |
$127.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.93
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Blue Shield of California Commercial |
$622.26
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$367.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$445.73
|
| Rate for Payer: Blue Shield of California Commercial |
$622.26
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$442.75
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: InnovAge PACE Commercial |
$402.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH CNTRL VNS 5FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.79
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: 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: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| 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 |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH CNTRL VNS 5FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| 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 |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH CNTRL VNS 5FR8CM DL BRK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
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 |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| 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: 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: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$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 CNTRL VNS 5FR8CM DL BRK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
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 |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$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 CNTRL VNS 7FR TL
|
Facility
|
IP
|
$233.94
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.79 |
| Max. Negotiated Rate |
$210.55 |
| Rate for Payer: Adventist Health Commercial |
$46.79
|
| Rate for Payer: Cash Price |
$128.67
|
| Rate for Payer: Central Health Plan Commercial |
$187.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.58
|
| Rate for Payer: EPIC Health Plan Senior |
$93.58
|
| Rate for Payer: Galaxy Health WC |
$198.85
|
| Rate for Payer: Global Benefits Group Commercial |
$140.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$210.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.79
|
| Rate for Payer: Multiplan Commercial |
$175.46
|
| Rate for Payer: Networks By Design Commercial |
$152.06
|
| Rate for Payer: Prime Health Services Commercial |
$198.85
|
|
|
HC CATH CNTRL VNS 7FR TL
|
Facility
|
OP
|
$233.94
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.79 |
| Max. Negotiated Rate |
$210.55 |
| Rate for Payer: Adventist Health Commercial |
$46.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$198.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.39
|
| Rate for Payer: Blue Shield of California Commercial |
$142.94
|
| Rate for Payer: Blue Shield of California EPN |
$93.34
|
| Rate for Payer: Cash Price |
$128.67
|
| Rate for Payer: Central Health Plan Commercial |
$187.15
|
| Rate for Payer: Cigna of CA HMO |
$149.72
|
| Rate for Payer: Cigna of CA PPO |
$173.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$198.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.58
|
| Rate for Payer: EPIC Health Plan Senior |
$93.58
|
| Rate for Payer: Galaxy Health WC |
$198.85
|
| Rate for Payer: Global Benefits Group Commercial |
$140.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$210.55
|
| Rate for Payer: InnovAge PACE Commercial |
$116.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.76
|
| Rate for Payer: Multiplan Commercial |
$175.46
|
| Rate for Payer: Networks By Design Commercial |
$152.06
|
| Rate for Payer: Prime Health Services Commercial |
$198.85
|
| Rate for Payer: Riverside University Health System MISP |
$93.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$140.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$140.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.97
|
| Rate for Payer: United Healthcare All Other HMO |
$116.97
|
| Rate for Payer: United Healthcare HMO Rider |
$116.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$198.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.85
|
| Rate for Payer: Vantage Medical Group Senior |
$198.85
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
IP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$2,532.15 |
| Rate for Payer: Adventist Health Commercial |
$562.70
|
| Rate for Payer: Blue Shield of California Commercial |
$2,174.84
|
| Rate for Payer: Blue Shield of California EPN |
$1,418.00
|
| Rate for Payer: Cash Price |
$1,547.43
|
| Rate for Payer: Central Health Plan Commercial |
$2,250.80
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,532.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,741.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$562.70
|
| Rate for Payer: Multiplan Commercial |
$2,110.12
|
| Rate for Payer: Networks By Design Commercial |
$1,406.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,055.91
|
| Rate for Payer: United Healthcare All Other HMO |
$1,027.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,005.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$921.42
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
OP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$2,532.15 |
| Rate for Payer: Adventist Health Commercial |
$562.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,547.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,110.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,284.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,557.83
|
| Rate for Payer: Blue Shield of California Commercial |
$2,174.84
|
| Rate for Payer: Blue Shield of California EPN |
$1,418.00
|
| Rate for Payer: Cash Price |
$1,547.43
|
| Rate for Payer: Central Health Plan Commercial |
$2,250.80
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,391.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,391.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,532.15
|
| Rate for Payer: InnovAge PACE Commercial |
$1,406.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,741.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$562.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,969.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,969.45
|
| Rate for Payer: Multiplan Commercial |
$2,110.12
|
| Rate for Payer: Networks By Design Commercial |
$1,406.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.47
|
| Rate for Payer: Riverside University Health System MISP |
$1,125.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,688.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,688.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,055.91
|
| Rate for Payer: United Healthcare All Other HMO |
$1,027.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,005.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$921.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,391.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$2,391.47
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
IP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$1,119.79 |
| Rate for Payer: Adventist Health Commercial |
$248.84
|
| Rate for Payer: Blue Shield of California Commercial |
$961.77
|
| Rate for Payer: Blue Shield of California EPN |
$627.08
|
| Rate for Payer: Cash Price |
$684.32
|
| Rate for Payer: Central Health Plan Commercial |
$995.37
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Senior |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,119.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$770.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.84
|
| Rate for Payer: Multiplan Commercial |
$933.16
|
| Rate for Payer: Networks By Design Commercial |
$622.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.95
|
| Rate for Payer: United Healthcare All Other HMO |
$454.51
|
| Rate for Payer: United Healthcare HMO Rider |
$444.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.48
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
OP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$1,119.79 |
| Rate for Payer: Adventist Health Commercial |
$248.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$684.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$933.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$568.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$688.92
|
| Rate for Payer: Blue Shield of California Commercial |
$961.77
|
| Rate for Payer: Blue Shield of California EPN |
$627.08
|
| Rate for Payer: Cash Price |
$684.32
|
| Rate for Payer: Central Health Plan Commercial |
$995.37
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,057.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,057.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Senior |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,119.79
|
| Rate for Payer: InnovAge PACE Commercial |
$622.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$770.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$870.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$870.95
|
| Rate for Payer: Multiplan Commercial |
$933.16
|
| Rate for Payer: Networks By Design Commercial |
$622.11
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: Riverside University Health System MISP |
$497.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$746.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$746.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.95
|
| Rate for Payer: United Healthcare All Other HMO |
$454.51
|
| Rate for Payer: United Healthcare HMO Rider |
$444.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,057.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,057.58
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
OP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$197.82 |
| Rate for Payer: Adventist Health Commercial |
$43.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$186.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.09
|
| Rate for Payer: Blue Shield of California Commercial |
$134.30
|
| Rate for Payer: Blue Shield of California EPN |
$87.70
|
| Rate for Payer: Cash Price |
$120.89
|
| Rate for Payer: Central Health Plan Commercial |
$175.84
|
| Rate for Payer: Cigna of CA HMO |
$140.67
|
| Rate for Payer: Cigna of CA PPO |
$162.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$186.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: EPIC Health Plan Senior |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.82
|
| Rate for Payer: InnovAge PACE Commercial |
$109.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.86
|
| Rate for Payer: Multiplan Commercial |
$164.85
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
| Rate for Payer: Riverside University Health System MISP |
$87.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.90
|
| Rate for Payer: United Healthcare All Other HMO |
$109.90
|
| Rate for Payer: United Healthcare HMO Rider |
$109.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$186.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.83
|
| Rate for Payer: Vantage Medical Group Senior |
$186.83
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
IP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$197.82 |
| Rate for Payer: Adventist Health Commercial |
$43.96
|
| Rate for Payer: Cash Price |
$120.89
|
| Rate for Payer: Central Health Plan Commercial |
$175.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: EPIC Health Plan Senior |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.96
|
| Rate for Payer: Multiplan Commercial |
$164.85
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,050.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,273.51
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
OP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$566.23 |
| Rate for Payer: Adventist Health Commercial |
$125.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$382.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$471.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.49
|
| Rate for Payer: Blue Shield of California Commercial |
$384.40
|
| Rate for Payer: Blue Shield of California EPN |
$251.03
|
| Rate for Payer: Cash Price |
$346.03
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: Cigna of CA HMO |
$402.65
|
| Rate for Payer: Cigna of CA PPO |
$465.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$534.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Senior |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: InnovAge PACE Commercial |
$314.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$440.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$440.40
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
| Rate for Payer: Riverside University Health System MISP |
$251.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$377.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.57
|
| Rate for Payer: United Healthcare All Other HMO |
$314.57
|
| Rate for Payer: United Healthcare HMO Rider |
$314.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$534.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.77
|
| Rate for Payer: Vantage Medical Group Senior |
$534.77
|
|
