|
HC CATH PICC PWR 6FR TL 40CM VPS
|
Facility
|
IP
|
$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: 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: 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 Medicare Advantage |
$757.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| 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: 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
|
|
|
HC CATH PICC PWR 6FR TL 55CM VPS
|
Facility
|
OP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$1,363.43 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$833.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,136.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$691.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$830.78
|
| Rate for Payer: Blue Shield of California Commercial |
$1,214.97
|
| Rate for Payer: Blue Shield of California EPN |
$763.52
|
| Rate for Payer: Cash Price |
$681.71
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.94
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,287.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,287.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,060.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,363.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$549.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,060.44
|
| Rate for Payer: Multiplan Commercial |
$1,136.19
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: Riverside University Health System MISP |
$605.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$908.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$908.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,287.68
|
|
|
HC CATH PICC PWR 6FR TL 55CM VPS
|
Facility
|
IP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$1,363.43 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1,214.97
|
| Rate for Payer: Blue Shield of California EPN |
$763.52
|
| Rate for Payer: Cash Price |
$681.71
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.94
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,060.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,363.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$961.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$893.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.98
|
| Rate for Payer: Multiplan Commercial |
$1,136.19
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
OP
|
$353.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$318.27 |
| Rate for Payer: Adventist Health Commercial |
$70.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$265.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$161.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.93
|
| Rate for Payer: Blue Shield of California Commercial |
$283.61
|
| Rate for Payer: Blue Shield of California EPN |
$178.23
|
| Rate for Payer: Cash Price |
$159.13
|
| Rate for Payer: Central Health Plan Commercial |
$282.90
|
| Rate for Payer: Cigna of CA HMO |
$247.54
|
| Rate for Payer: Cigna of CA PPO |
$247.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$300.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$300.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.45
|
| Rate for Payer: EPIC Health Plan Senior |
$141.45
|
| Rate for Payer: Galaxy Health WC |
$300.59
|
| Rate for Payer: Global Benefits Group Commercial |
$212.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$318.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$247.54
|
| Rate for Payer: Multiplan Commercial |
$265.22
|
| Rate for Payer: Networks By Design Commercial |
$176.81
|
| Rate for Payer: Prime Health Services Commercial |
$300.59
|
| Rate for Payer: Riverside University Health System MISP |
$141.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$212.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$212.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$129.18
|
| Rate for Payer: United Healthcare HMO Rider |
$126.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$300.59
|
| Rate for Payer: Vantage Medical Group Senior |
$300.59
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
IP
|
$353.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$318.27 |
| Rate for Payer: Adventist Health Commercial |
$70.73
|
| Rate for Payer: Blue Shield of California Commercial |
$283.61
|
| Rate for Payer: Blue Shield of California EPN |
$178.23
|
| Rate for Payer: Cash Price |
$159.13
|
| Rate for Payer: Central Health Plan Commercial |
$282.90
|
| Rate for Payer: Cigna of CA HMO |
$247.54
|
| Rate for Payer: Cigna of CA PPO |
$247.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.45
|
| Rate for Payer: EPIC Health Plan Senior |
$141.45
|
| Rate for Payer: Galaxy Health WC |
$300.59
|
| Rate for Payer: Global Benefits Group Commercial |
$212.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$318.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.73
|
| Rate for Payer: Multiplan Commercial |
$265.22
|
| Rate for Payer: Networks By Design Commercial |
$176.81
|
| Rate for Payer: Prime Health Services Commercial |
$300.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$129.18
|
| Rate for Payer: United Healthcare HMO Rider |
$126.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.81
|
|
|
HC CATH PICC SL ARROW VPS STYLET
|
Facility
|
OP
|
$1,674.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$334.88 |
| Max. Negotiated Rate |
$1,506.96 |
| Rate for Payer: Adventist Health Commercial |
$334.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$920.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,255.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$764.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$918.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,342.87
|
| Rate for Payer: Blue Shield of California EPN |
$843.90
|
| Rate for Payer: Cash Price |
$753.48
|
| Rate for Payer: Central Health Plan Commercial |
$1,339.52
|
| Rate for Payer: Cigna of CA HMO |
$1,172.08
|
| Rate for Payer: Cigna of CA PPO |
$1,172.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,423.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,423.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Senior |
$669.76
|
| Rate for Payer: Galaxy Health WC |
$1,423.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,506.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$607.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,172.08
|
| Rate for Payer: Multiplan Commercial |
$1,255.80
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.24
|
| Rate for Payer: Riverside University Health System MISP |
$669.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,004.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,004.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.40
|
| Rate for Payer: United Healthcare All Other HMO |
$611.66
|
| Rate for Payer: United Healthcare HMO Rider |
$598.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,423.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,423.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,423.24
|
|
|
HC CATH PICC SL ARROW VPS STYLET
|
Facility
|
IP
|
$1,674.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$334.88 |
| Max. Negotiated Rate |
$1,506.96 |
| Rate for Payer: Adventist Health Commercial |
$334.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,342.87
|
| Rate for Payer: Blue Shield of California EPN |
$843.90
|
| Rate for Payer: Cash Price |
$753.48
|
| Rate for Payer: Central Health Plan Commercial |
$1,339.52
|
| Rate for Payer: Cigna of CA HMO |
$1,172.08
|
| Rate for Payer: Cigna of CA PPO |
$1,172.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.76
|
| Rate for Payer: EPIC Health Plan Senior |
$669.76
|
| Rate for Payer: Galaxy Health WC |
$1,423.24
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,506.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.88
|
| Rate for Payer: Multiplan Commercial |
$1,255.80
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.40
|
| Rate for Payer: United Healthcare All Other HMO |
$611.66
|
| Rate for Payer: United Healthcare HMO Rider |
$598.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.37
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$588.68
|
| Rate for Payer: Blue Shield of California Commercial |
$641.61
|
| Rate for Payer: Blue Shield of California EPN |
$403.79
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$367.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$642.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
OP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$361.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$492.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$317.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.00
|
| Rate for Payer: Blue Shield of California Commercial |
$416.35
|
| Rate for Payer: Blue Shield of California EPN |
$262.02
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Central Health Plan Commercial |
$525.36
|
| Rate for Payer: Cigna of CA HMO |
$420.29
|
| Rate for Payer: Cigna of CA PPO |
$485.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$558.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$558.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$238.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$387.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$459.69
|
| Rate for Payer: Multiplan Commercial |
$492.52
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
| Rate for Payer: Riverside University Health System MISP |
$262.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.35
|
| Rate for Payer: United Healthcare All Other HMO |
$328.35
|
| Rate for Payer: United Healthcare HMO Rider |
$328.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.20
|
| Rate for Payer: Vantage Medical Group Senior |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
IP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$591.03 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Cash Price |
$295.52
|
| Rate for Payer: Central Health Plan Commercial |
$525.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$387.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.34
|
| Rate for Payer: Multiplan Commercial |
$492.52
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
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 |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| 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 |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$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 PIGTAIL 5.5F 70CM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.70
|
| Rate for Payer: Blue Shield of California Commercial |
$71.60
|
| Rate for Payer: Blue Shield of California EPN |
$45.06
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Cigna of CA HMO |
$72.28
|
| Rate for Payer: Cigna of CA PPO |
$83.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Riverside University Health System MISP |
$45.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.47
|
| Rate for Payer: United Healthcare All Other HMO |
$56.47
|
| Rate for Payer: United Healthcare HMO Rider |
$56.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
OP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.36
|
| Rate for Payer: Blue Shield of California Commercial |
$72.33
|
| Rate for Payer: Blue Shield of California EPN |
$45.52
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$79.86
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Riverside University Health System MISP |
$45.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
IP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
OP
|
$608.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$547.26 |
| Rate for Payer: Adventist Health Commercial |
$121.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$516.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$334.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$456.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$277.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$333.47
|
| Rate for Payer: Blue Shield of California Commercial |
$487.67
|
| Rate for Payer: Blue Shield of California EPN |
$306.47
|
| Rate for Payer: Cash Price |
$273.63
|
| Rate for Payer: Central Health Plan Commercial |
$486.46
|
| Rate for Payer: Cigna of CA HMO |
$425.65
|
| Rate for Payer: Cigna of CA PPO |
$425.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$516.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$516.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$516.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$425.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.23
|
| Rate for Payer: EPIC Health Plan Senior |
$243.23
|
| Rate for Payer: Galaxy Health WC |
$516.86
|
| Rate for Payer: Global Benefits Group Commercial |
$364.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$547.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$386.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$220.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$358.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.65
|
| Rate for Payer: Multiplan Commercial |
$456.05
|
| Rate for Payer: Networks By Design Commercial |
$304.04
|
| Rate for Payer: Prime Health Services Commercial |
$516.86
|
| Rate for Payer: Riverside University Health System MISP |
$243.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$364.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$364.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.21
|
| Rate for Payer: United Healthcare All Other HMO |
$222.13
|
| Rate for Payer: United Healthcare HMO Rider |
$217.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$516.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$516.86
|
| Rate for Payer: Vantage Medical Group Senior |
$516.86
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
IP
|
$608.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$547.26 |
| Rate for Payer: Adventist Health Commercial |
$121.61
|
| Rate for Payer: Blue Shield of California Commercial |
$487.67
|
| Rate for Payer: Blue Shield of California EPN |
$306.47
|
| Rate for Payer: Cash Price |
$273.63
|
| Rate for Payer: Central Health Plan Commercial |
$486.46
|
| Rate for Payer: Cigna of CA HMO |
$425.65
|
| Rate for Payer: Cigna of CA PPO |
$425.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$425.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.23
|
| Rate for Payer: EPIC Health Plan Senior |
$243.23
|
| Rate for Payer: Galaxy Health WC |
$516.86
|
| Rate for Payer: Global Benefits Group Commercial |
$364.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$547.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$386.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$358.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.61
|
| Rate for Payer: Multiplan Commercial |
$456.05
|
| Rate for Payer: Networks By Design Commercial |
$304.04
|
| Rate for Payer: Prime Health Services Commercial |
$516.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.21
|
| Rate for Payer: United Healthcare All Other HMO |
$222.13
|
| Rate for Payer: United Healthcare HMO Rider |
$217.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.14
|
|
|
HC CATH PMO LICOX
|
Facility
|
OP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,398.53 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,293.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,076.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,832.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,828.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,196.58
|
| Rate for Payer: Blue Shield of California Commercial |
$2,394.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,506.68
|
| Rate for Payer: Cash Price |
$1,699.26
|
| Rate for Payer: Central Health Plan Commercial |
$3,020.91
|
| Rate for Payer: Cigna of CA HMO |
$2,416.73
|
| Rate for Payer: Cigna of CA PPO |
$2,794.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,209.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,209.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,643.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,398.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,397.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,370.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,227.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,643.30
|
| Rate for Payer: Multiplan Commercial |
$2,832.11
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
| Rate for Payer: Riverside University Health System MISP |
$1,510.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,265.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,265.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,888.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1,888.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1,888.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,888.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Senior |
$3,209.72
|
|
|
HC CATH PMO LICOX
|
Facility
|
IP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,398.53 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Cash Price |
$1,699.26
|
| Rate for Payer: Central Health Plan Commercial |
$3,020.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,643.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,398.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,397.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,227.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.23
|
| Rate for Payer: Multiplan Commercial |
$2,832.11
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
|
|
HC CATH POLY PICC KIT 1.4FR
|
Facility
|
IP
|
$598.00
|
|
| Hospital Charge Code |
901698961
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$269.10
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$418.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC CATH POLY PICC KIT 1.4FR
|
Facility
|
OP
|
$598.00
|
|
| Hospital Charge Code |
901698961
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$289.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.86
|
| Rate for Payer: Blue Shield of California Commercial |
$379.13
|
| Rate for Payer: Blue Shield of California EPN |
$238.60
|
| Rate for Payer: Cash Price |
$269.10
|
| Rate for Payer: Central Health Plan Commercial |
$478.40
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$508.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$508.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$508.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$418.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$538.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$217.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$448.50
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Riverside University Health System MISP |
$239.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$299.00
|
| Rate for Payer: United Healthcare All Other HMO |
$299.00
|
| Rate for Payer: United Healthcare HMO Rider |
$299.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$299.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$508.30
|
| Rate for Payer: Vantage Medical Group Senior |
$508.30
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$178.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138.44
|
| Rate for Payer: Blue Shield of California Commercial |
$150.89
|
| Rate for Payer: Blue Shield of California EPN |
$94.96
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$202.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$140.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Riverside University Health System MISP |
$95.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$140.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
