|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
IP
|
$1,438.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.66 |
| Max. Negotiated Rate |
$1,294.45 |
| Rate for Payer: Adventist Health Commercial |
$287.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,153.50
|
| Rate for Payer: Blue Shield of California EPN |
$724.89
|
| Rate for Payer: Cash Price |
$647.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.62
|
| Rate for Payer: Cigna of CA HMO |
$1,006.80
|
| Rate for Payer: Cigna of CA PPO |
$1,006.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,006.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.31
|
| Rate for Payer: EPIC Health Plan Senior |
$575.31
|
| Rate for Payer: Galaxy Health WC |
$1,222.54
|
| Rate for Payer: Global Benefits Group Commercial |
$862.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$913.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$848.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.66
|
| Rate for Payer: Multiplan Commercial |
$1,078.71
|
| Rate for Payer: Networks By Design Commercial |
$719.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$539.79
|
| Rate for Payer: United Healthcare All Other HMO |
$525.40
|
| Rate for Payer: United Healthcare HMO Rider |
$514.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.04
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
OP
|
$1,438.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.66 |
| Max. Negotiated Rate |
$1,294.45 |
| Rate for Payer: Adventist Health Commercial |
$287.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$791.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,078.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$656.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$788.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,153.50
|
| Rate for Payer: Blue Shield of California EPN |
$724.89
|
| Rate for Payer: Cash Price |
$647.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.62
|
| Rate for Payer: Cigna of CA HMO |
$1,006.80
|
| Rate for Payer: Cigna of CA PPO |
$1,006.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,222.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,222.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,006.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.31
|
| Rate for Payer: EPIC Health Plan Senior |
$575.31
|
| Rate for Payer: Galaxy Health WC |
$1,222.54
|
| Rate for Payer: Global Benefits Group Commercial |
$862.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$913.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$848.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,006.80
|
| Rate for Payer: Multiplan Commercial |
$1,078.71
|
| Rate for Payer: Networks By Design Commercial |
$719.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.54
|
| Rate for Payer: Riverside University Health System MISP |
$575.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$862.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$862.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$539.79
|
| Rate for Payer: United Healthcare All Other HMO |
$525.40
|
| Rate for Payer: United Healthcare HMO Rider |
$514.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,222.54
|
| Rate for Payer: Vantage Medical Group Senior |
$1,222.54
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
OP
|
$1,514.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.83 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Adventist Health Commercial |
$302.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$832.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,135.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$691.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$830.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1,214.34
|
| Rate for Payer: Blue Shield of California EPN |
$763.13
|
| Rate for Payer: Cash Price |
$681.36
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.31
|
| Rate for Payer: Cigna of CA HMO |
$1,059.90
|
| Rate for Payer: Cigna of CA PPO |
$1,059.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,287.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,287.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.66
|
| Rate for Payer: EPIC Health Plan Senior |
$605.66
|
| Rate for Payer: Galaxy Health WC |
$1,287.02
|
| Rate for Payer: Global Benefits Group Commercial |
$908.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,362.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$549.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,059.90
|
| Rate for Payer: Multiplan Commercial |
$1,135.61
|
| Rate for Payer: Networks By Design Commercial |
$757.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.02
|
| Rate for Payer: Riverside University Health System MISP |
$605.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$908.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$908.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.26
|
| Rate for Payer: United Healthcare All Other HMO |
$553.12
|
| Rate for Payer: United Healthcare HMO Rider |
$541.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,287.02
|
| Rate for Payer: Vantage Medical Group Senior |
$1,287.02
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
IP
|
$1,514.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.83 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Adventist Health Commercial |
$302.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1,214.34
|
| Rate for Payer: Blue Shield of California EPN |
$763.13
|
| Rate for Payer: Cash Price |
$681.36
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.31
|
| Rate for Payer: Cigna of CA HMO |
$1,059.90
|
| Rate for Payer: Cigna of CA PPO |
$1,059.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.66
|
| Rate for Payer: EPIC Health Plan Senior |
$605.66
|
| Rate for Payer: Galaxy Health WC |
$1,287.02
|
| Rate for Payer: Global Benefits Group Commercial |
$908.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,362.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.83
|
| Rate for Payer: Multiplan Commercial |
$1,135.61
|
| Rate for Payer: Networks By Design Commercial |
$757.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.26
|
| Rate for Payer: United Healthcare All Other HMO |
$553.12
|
| Rate for Payer: United Healthcare HMO Rider |
$541.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.88
|
|
|
HC CATH PICC PWR 4.5FR SL 40CM
|
Facility
|
OP
|
$1,395.32
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$279.06 |
| Max. Negotiated Rate |
$1,255.79 |
| Rate for Payer: Adventist Health Commercial |
$279.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$767.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,046.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$637.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$765.19
|
| Rate for Payer: Blue Shield of California Commercial |
$1,119.05
|
| Rate for Payer: Blue Shield of California EPN |
$703.24
|
| Rate for Payer: Cash Price |
$627.89
|
| Rate for Payer: Central Health Plan Commercial |
$1,116.26
|
| Rate for Payer: Cigna of CA HMO |
$976.72
|
| Rate for Payer: Cigna of CA PPO |
$976.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,186.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,186.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$976.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$558.13
|
| Rate for Payer: EPIC Health Plan Senior |
$558.13
|
| Rate for Payer: Galaxy Health WC |
$1,186.02
|
| Rate for Payer: Global Benefits Group Commercial |
$837.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,255.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$886.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$506.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$823.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$976.72
|
| Rate for Payer: Multiplan Commercial |
$1,046.49
|
| Rate for Payer: Networks By Design Commercial |
$697.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,186.02
|
| Rate for Payer: Riverside University Health System MISP |
$558.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$837.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$837.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$523.66
|
| Rate for Payer: United Healthcare All Other HMO |
$509.71
|
| Rate for Payer: United Healthcare HMO Rider |
$498.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$456.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,186.02
|
| Rate for Payer: Vantage Medical Group Senior |
$1,186.02
|
|
|
HC CATH PICC PWR 4.5FR SL 40CM
|
Facility
|
IP
|
$1,395.32
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$279.06 |
| Max. Negotiated Rate |
$1,255.79 |
| Rate for Payer: Adventist Health Commercial |
$279.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,119.05
|
| Rate for Payer: Blue Shield of California EPN |
$703.24
|
| Rate for Payer: Cash Price |
$627.89
|
| Rate for Payer: Central Health Plan Commercial |
$1,116.26
|
| Rate for Payer: Cigna of CA HMO |
$976.72
|
| Rate for Payer: Cigna of CA PPO |
$976.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$976.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$558.13
|
| Rate for Payer: EPIC Health Plan Senior |
$558.13
|
| Rate for Payer: Galaxy Health WC |
$1,186.02
|
| Rate for Payer: Global Benefits Group Commercial |
$837.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,255.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$886.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$823.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.06
|
| Rate for Payer: Multiplan Commercial |
$1,046.49
|
| Rate for Payer: Networks By Design Commercial |
$697.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,186.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$523.66
|
| Rate for Payer: United Healthcare All Other HMO |
$509.71
|
| Rate for Payer: United Healthcare HMO Rider |
$498.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$456.97
|
|
|
HC CATH PICC PWR 4FR SL
|
Facility
|
OP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Adventist Health Commercial |
$255.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$702.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$958.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$583.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$700.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,024.68
|
| Rate for Payer: Blue Shield of California EPN |
$643.94
|
| Rate for Payer: Cash Price |
$574.94
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,086.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,086.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$894.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Senior |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$811.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$463.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$753.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$894.36
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Networks By Design Commercial |
$638.83
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: Riverside University Health System MISP |
$511.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$766.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$766.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.50
|
| Rate for Payer: United Healthcare All Other HMO |
$466.73
|
| Rate for Payer: United Healthcare HMO Rider |
$456.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,086.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,086.00
|
|
|
HC CATH PICC PWR 4FR SL
|
Facility
|
IP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Adventist Health Commercial |
$255.53
|
| Rate for Payer: Blue Shield of California Commercial |
$1,024.68
|
| Rate for Payer: Blue Shield of California EPN |
$643.94
|
| Rate for Payer: Cash Price |
$574.94
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$894.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Senior |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$811.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$753.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Networks By Design Commercial |
$638.83
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.50
|
| Rate for Payer: United Healthcare All Other HMO |
$466.73
|
| Rate for Payer: United Healthcare HMO Rider |
$456.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.43
|
|
|
HC CATH PICC PWR 4FR SL 40CM VPS
|
Facility
|
IP
|
$1,225.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$245.02 |
| Max. Negotiated Rate |
$1,102.61 |
| Rate for Payer: Adventist Health Commercial |
$245.02
|
| Rate for Payer: Blue Shield of California Commercial |
$982.55
|
| Rate for Payer: Blue Shield of California EPN |
$617.46
|
| Rate for Payer: Cash Price |
$551.30
|
| Rate for Payer: Central Health Plan Commercial |
$980.10
|
| Rate for Payer: Cigna of CA HMO |
$857.58
|
| Rate for Payer: Cigna of CA PPO |
$857.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$857.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$490.05
|
| Rate for Payer: EPIC Health Plan Senior |
$490.05
|
| Rate for Payer: Galaxy Health WC |
$1,041.35
|
| Rate for Payer: Global Benefits Group Commercial |
$735.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,102.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$777.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$722.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$245.02
|
| Rate for Payer: Multiplan Commercial |
$918.84
|
| Rate for Payer: Networks By Design Commercial |
$612.56
|
| Rate for Payer: Prime Health Services Commercial |
$1,041.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$459.79
|
| Rate for Payer: United Healthcare All Other HMO |
$447.54
|
| Rate for Payer: United Healthcare HMO Rider |
$437.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$401.23
|
|
|
HC CATH PICC PWR 4FR SL 40CM VPS
|
Facility
|
OP
|
$1,225.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$245.02 |
| Max. Negotiated Rate |
$1,102.61 |
| Rate for Payer: Adventist Health Commercial |
$245.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$673.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$918.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$559.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.86
|
| Rate for Payer: Blue Shield of California Commercial |
$982.55
|
| Rate for Payer: Blue Shield of California EPN |
$617.46
|
| Rate for Payer: Cash Price |
$551.30
|
| Rate for Payer: Central Health Plan Commercial |
$980.10
|
| Rate for Payer: Cigna of CA HMO |
$857.58
|
| Rate for Payer: Cigna of CA PPO |
$857.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,041.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,041.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$857.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$490.05
|
| Rate for Payer: EPIC Health Plan Senior |
$490.05
|
| Rate for Payer: Galaxy Health WC |
$1,041.35
|
| Rate for Payer: Global Benefits Group Commercial |
$735.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,102.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$777.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$444.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$722.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$245.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$857.58
|
| Rate for Payer: Multiplan Commercial |
$918.84
|
| Rate for Payer: Networks By Design Commercial |
$612.56
|
| Rate for Payer: Prime Health Services Commercial |
$1,041.35
|
| Rate for Payer: Riverside University Health System MISP |
$490.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$735.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$735.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$459.79
|
| Rate for Payer: United Healthcare All Other HMO |
$447.54
|
| Rate for Payer: United Healthcare HMO Rider |
$437.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$401.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,041.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,041.35
|
|
|
HC CATH PICC PWR 5.5FR 45CM DL
|
Facility
|
OP
|
$1,717.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.44 |
| Max. Negotiated Rate |
$1,545.46 |
| Rate for Payer: Adventist Health Commercial |
$343.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$944.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,287.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$784.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$941.70
|
| Rate for Payer: Blue Shield of California Commercial |
$1,377.18
|
| Rate for Payer: Blue Shield of California EPN |
$865.46
|
| Rate for Payer: Cash Price |
$772.73
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.74
|
| Rate for Payer: Cigna of CA HMO |
$1,202.03
|
| Rate for Payer: Cigna of CA PPO |
$1,202.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,459.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,459.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,202.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.87
|
| Rate for Payer: EPIC Health Plan Senior |
$686.87
|
| Rate for Payer: Galaxy Health WC |
$1,459.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,090.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$623.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,013.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,202.03
|
| Rate for Payer: Multiplan Commercial |
$1,287.88
|
| Rate for Payer: Networks By Design Commercial |
$858.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.60
|
| Rate for Payer: Riverside University Health System MISP |
$686.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,030.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,030.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.46
|
| Rate for Payer: United Healthcare All Other HMO |
$627.29
|
| Rate for Payer: United Healthcare HMO Rider |
$613.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$562.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,459.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,459.60
|
|
|
HC CATH PICC PWR 5.5FR 45CM DL
|
Facility
|
IP
|
$1,717.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.44 |
| Max. Negotiated Rate |
$1,545.46 |
| Rate for Payer: Adventist Health Commercial |
$343.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,377.18
|
| Rate for Payer: Blue Shield of California EPN |
$865.46
|
| Rate for Payer: Cash Price |
$772.73
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.74
|
| Rate for Payer: Cigna of CA HMO |
$1,202.03
|
| Rate for Payer: Cigna of CA PPO |
$1,202.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,202.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.87
|
| Rate for Payer: EPIC Health Plan Senior |
$686.87
|
| Rate for Payer: Galaxy Health WC |
$1,459.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,090.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,013.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.44
|
| Rate for Payer: Multiplan Commercial |
$1,287.88
|
| Rate for Payer: Networks By Design Commercial |
$858.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.46
|
| Rate for Payer: United Healthcare All Other HMO |
$627.29
|
| Rate for Payer: United Healthcare HMO Rider |
$613.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$562.38
|
|
|
HC CATH PICC PWR 5.5FR 50CM DL
|
Facility
|
IP
|
$1,459.17
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.83 |
| Max. Negotiated Rate |
$1,313.25 |
| Rate for Payer: Adventist Health Commercial |
$291.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1,170.25
|
| Rate for Payer: Blue Shield of California EPN |
$735.42
|
| Rate for Payer: Cash Price |
$656.63
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.34
|
| Rate for Payer: Cigna of CA HMO |
$1,021.42
|
| Rate for Payer: Cigna of CA PPO |
$1,021.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,021.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$583.67
|
| Rate for Payer: EPIC Health Plan Senior |
$583.67
|
| Rate for Payer: Galaxy Health WC |
$1,240.29
|
| Rate for Payer: Global Benefits Group Commercial |
$875.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$926.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$860.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.83
|
| Rate for Payer: Multiplan Commercial |
$1,094.38
|
| Rate for Payer: Networks By Design Commercial |
$729.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.63
|
| Rate for Payer: United Healthcare All Other HMO |
$533.03
|
| Rate for Payer: United Healthcare HMO Rider |
$521.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$477.88
|
|
|
HC CATH PICC PWR 5.5FR 50CM DL
|
Facility
|
OP
|
$1,459.17
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.83 |
| Max. Negotiated Rate |
$1,313.25 |
| Rate for Payer: Adventist Health Commercial |
$291.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$802.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,094.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$666.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$800.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1,170.25
|
| Rate for Payer: Blue Shield of California EPN |
$735.42
|
| Rate for Payer: Cash Price |
$656.63
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.34
|
| Rate for Payer: Cigna of CA HMO |
$1,021.42
|
| Rate for Payer: Cigna of CA PPO |
$1,021.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,240.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,240.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,021.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$583.67
|
| Rate for Payer: EPIC Health Plan Senior |
$583.67
|
| Rate for Payer: Galaxy Health WC |
$1,240.29
|
| Rate for Payer: Global Benefits Group Commercial |
$875.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$926.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$529.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$860.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,021.42
|
| Rate for Payer: Multiplan Commercial |
$1,094.38
|
| Rate for Payer: Networks By Design Commercial |
$729.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.29
|
| Rate for Payer: Riverside University Health System MISP |
$583.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$875.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.63
|
| Rate for Payer: United Healthcare All Other HMO |
$533.03
|
| Rate for Payer: United Healthcare HMO Rider |
$521.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$477.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,240.29
|
| Rate for Payer: Vantage Medical Group Senior |
$1,240.29
|
|
|
HC CATH PICC PWR 5.5FR 55CM DL
|
Facility
|
IP
|
$1,572.88
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,415.59 |
| Rate for Payer: Adventist Health Commercial |
$314.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,261.45
|
| Rate for Payer: Blue Shield of California EPN |
$792.73
|
| Rate for Payer: Cash Price |
$707.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,258.30
|
| Rate for Payer: Cigna of CA HMO |
$1,101.02
|
| Rate for Payer: Cigna of CA PPO |
$1,101.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,101.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$629.15
|
| Rate for Payer: EPIC Health Plan Senior |
$629.15
|
| Rate for Payer: Galaxy Health WC |
$1,336.95
|
| Rate for Payer: Global Benefits Group Commercial |
$943.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,415.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$998.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$928.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.58
|
| Rate for Payer: Multiplan Commercial |
$1,179.66
|
| Rate for Payer: Networks By Design Commercial |
$786.44
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.30
|
| Rate for Payer: United Healthcare All Other HMO |
$574.57
|
| Rate for Payer: United Healthcare HMO Rider |
$562.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.12
|
|
|
HC CATH PICC PWR 5.5FR 55CM DL
|
Facility
|
OP
|
$1,572.88
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,415.59 |
| Rate for Payer: Adventist Health Commercial |
$314.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$865.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,179.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$718.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$862.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,261.45
|
| Rate for Payer: Blue Shield of California EPN |
$792.73
|
| Rate for Payer: Cash Price |
$707.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,258.30
|
| Rate for Payer: Cigna of CA HMO |
$1,101.02
|
| Rate for Payer: Cigna of CA PPO |
$1,101.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,336.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,336.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,101.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$629.15
|
| Rate for Payer: EPIC Health Plan Senior |
$629.15
|
| Rate for Payer: Galaxy Health WC |
$1,336.95
|
| Rate for Payer: Global Benefits Group Commercial |
$943.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,415.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$998.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$570.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$928.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,101.02
|
| Rate for Payer: Multiplan Commercial |
$1,179.66
|
| Rate for Payer: Networks By Design Commercial |
$786.44
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.95
|
| Rate for Payer: Riverside University Health System MISP |
$629.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$943.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$943.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.30
|
| Rate for Payer: United Healthcare All Other HMO |
$574.57
|
| Rate for Payer: United Healthcare HMO Rider |
$562.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,336.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,336.95
|
|
|
HC CATH PICC PWR 5.5FR DL 40CM
|
Facility
|
OP
|
$1,400.29
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.06 |
| Max. Negotiated Rate |
$1,260.26 |
| Rate for Payer: Adventist Health Commercial |
$280.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$770.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,050.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$639.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$767.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,123.03
|
| Rate for Payer: Blue Shield of California EPN |
$705.75
|
| Rate for Payer: Cash Price |
$630.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.23
|
| Rate for Payer: Cigna of CA HMO |
$980.20
|
| Rate for Payer: Cigna of CA PPO |
$980.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,190.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,190.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$980.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.12
|
| Rate for Payer: EPIC Health Plan Senior |
$560.12
|
| Rate for Payer: Galaxy Health WC |
$1,190.25
|
| Rate for Payer: Global Benefits Group Commercial |
$840.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$889.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$508.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$826.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$980.20
|
| Rate for Payer: Multiplan Commercial |
$1,050.22
|
| Rate for Payer: Networks By Design Commercial |
$700.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.25
|
| Rate for Payer: Riverside University Health System MISP |
$560.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$840.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$840.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.53
|
| Rate for Payer: United Healthcare All Other HMO |
$511.53
|
| Rate for Payer: United Healthcare HMO Rider |
$500.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,190.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,190.25
|
|
|
HC CATH PICC PWR 5.5FR DL 40CM
|
Facility
|
IP
|
$1,400.29
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.06 |
| Max. Negotiated Rate |
$1,260.26 |
| Rate for Payer: Adventist Health Commercial |
$280.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,123.03
|
| Rate for Payer: Blue Shield of California EPN |
$705.75
|
| Rate for Payer: Cash Price |
$630.13
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.23
|
| Rate for Payer: Cigna of CA HMO |
$980.20
|
| Rate for Payer: Cigna of CA PPO |
$980.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$980.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.12
|
| Rate for Payer: EPIC Health Plan Senior |
$560.12
|
| Rate for Payer: Galaxy Health WC |
$1,190.25
|
| Rate for Payer: Global Benefits Group Commercial |
$840.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$889.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$826.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$1,050.22
|
| Rate for Payer: Networks By Design Commercial |
$700.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.53
|
| Rate for Payer: United Healthcare All Other HMO |
$511.53
|
| Rate for Payer: United Healthcare HMO Rider |
$500.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.59
|
|
|
HC CATH PICC PWR 5FR DL 40CM VPS
|
Facility
|
OP
|
$1,298.72
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.74 |
| Max. Negotiated Rate |
$1,168.85 |
| Rate for Payer: Adventist Health Commercial |
$259.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$714.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$974.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$593.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$712.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,041.57
|
| Rate for Payer: Blue Shield of California EPN |
$654.55
|
| Rate for Payer: Cash Price |
$584.42
|
| Rate for Payer: Central Health Plan Commercial |
$1,038.98
|
| Rate for Payer: Cigna of CA HMO |
$909.10
|
| Rate for Payer: Cigna of CA PPO |
$909.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,103.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,103.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$909.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$519.49
|
| Rate for Payer: EPIC Health Plan Senior |
$519.49
|
| Rate for Payer: Galaxy Health WC |
$1,103.91
|
| Rate for Payer: Global Benefits Group Commercial |
$779.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,168.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$824.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$471.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$766.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$909.10
|
| Rate for Payer: Multiplan Commercial |
$974.04
|
| Rate for Payer: Networks By Design Commercial |
$649.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,103.91
|
| Rate for Payer: Riverside University Health System MISP |
$519.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$779.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$779.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$487.41
|
| Rate for Payer: United Healthcare All Other HMO |
$474.42
|
| Rate for Payer: United Healthcare HMO Rider |
$464.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,103.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,103.91
|
|
|
HC CATH PICC PWR 5FR DL 40CM VPS
|
Facility
|
IP
|
$1,298.72
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.74 |
| Max. Negotiated Rate |
$1,168.85 |
| Rate for Payer: Adventist Health Commercial |
$259.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,041.57
|
| Rate for Payer: Blue Shield of California EPN |
$654.55
|
| Rate for Payer: Cash Price |
$584.42
|
| Rate for Payer: Central Health Plan Commercial |
$1,038.98
|
| Rate for Payer: Cigna of CA HMO |
$909.10
|
| Rate for Payer: Cigna of CA PPO |
$909.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$909.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$519.49
|
| Rate for Payer: EPIC Health Plan Senior |
$519.49
|
| Rate for Payer: Galaxy Health WC |
$1,103.91
|
| Rate for Payer: Global Benefits Group Commercial |
$779.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,168.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$824.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$766.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.74
|
| Rate for Payer: Multiplan Commercial |
$974.04
|
| Rate for Payer: Networks By Design Commercial |
$649.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,103.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$487.41
|
| Rate for Payer: United Healthcare All Other HMO |
$474.42
|
| Rate for Payer: United Healthcare HMO Rider |
$464.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.33
|
|
|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
OP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$1,299.96 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$794.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,083.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$659.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$792.11
|
| Rate for Payer: Blue Shield of California Commercial |
$1,158.41
|
| Rate for Payer: Blue Shield of California EPN |
$727.98
|
| Rate for Payer: Cash Price |
$649.98
|
| Rate for Payer: Central Health Plan Commercial |
$1,155.52
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,227.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,227.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,299.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$524.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$852.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,011.08
|
| Rate for Payer: Multiplan Commercial |
$1,083.30
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: Riverside University Health System MISP |
$577.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$866.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$866.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Senior |
$1,227.74
|
|
|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
IP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$1,299.96 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,158.41
|
| Rate for Payer: Blue Shield of California EPN |
$727.98
|
| Rate for Payer: Cash Price |
$649.98
|
| Rate for Payer: Central Health Plan Commercial |
$1,155.52
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,011.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,299.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$917.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$852.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.88
|
| Rate for Payer: Multiplan Commercial |
$1,083.30
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
OP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$1,334.03 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$815.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,111.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$676.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$812.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1,188.77
|
| Rate for Payer: Blue Shield of California EPN |
$747.06
|
| Rate for Payer: Cash Price |
$667.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,185.81
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,259.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,259.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,037.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,334.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$941.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$538.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$874.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,037.58
|
| Rate for Payer: Multiplan Commercial |
$1,111.69
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: Riverside University Health System MISP |
$592.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$889.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$889.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Senior |
$1,259.92
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
IP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$1,334.03 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,188.77
|
| Rate for Payer: Blue Shield of California EPN |
$747.06
|
| Rate for Payer: Cash Price |
$667.02
|
| Rate for Payer: Central Health Plan Commercial |
$1,185.81
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,037.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,334.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$941.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$874.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.45
|
| Rate for Payer: Multiplan Commercial |
$1,111.69
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
|
|
HC CATH PICC PWR 6FR TL 40CM VPS
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607741
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$962.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$586.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$703.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,029.29
|
| Rate for Payer: Blue Shield of California EPN |
$646.83
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,090.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$814.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$465.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$757.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$898.38
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Riverside University Health System MISP |
$513.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
