|
HC CATH POWERLINE TUNNELED
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.54
|
| Rate for Payer: Blue Shield of California EPN |
$741.89
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$934.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$672.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$807.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.54
|
| Rate for Payer: Blue Shield of California EPN |
$741.89
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,251.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$934.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$534.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,030.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Riverside University Health System MISP |
$588.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
OP
|
$2,083.02
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.60 |
| Max. Negotiated Rate |
$1,874.72 |
| Rate for Payer: Adventist Health Commercial |
$416.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,145.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,562.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$951.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,142.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,670.58
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.84
|
| Rate for Payer: Cash Price |
$937.36
|
| Rate for Payer: Central Health Plan Commercial |
$1,666.42
|
| Rate for Payer: Cigna of CA HMO |
$1,458.11
|
| Rate for Payer: Cigna of CA PPO |
$1,458.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,770.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,770.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,458.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$833.21
|
| Rate for Payer: EPIC Health Plan Senior |
$833.21
|
| Rate for Payer: Galaxy Health WC |
$1,770.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1,249.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,874.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,322.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$756.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,228.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,458.11
|
| Rate for Payer: Multiplan Commercial |
$1,562.27
|
| Rate for Payer: Networks By Design Commercial |
$1,041.51
|
| Rate for Payer: Prime Health Services Commercial |
$1,770.57
|
| Rate for Payer: Riverside University Health System MISP |
$833.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,249.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,249.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.76
|
| Rate for Payer: United Healthcare All Other HMO |
$760.93
|
| Rate for Payer: United Healthcare HMO Rider |
$744.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,770.57
|
| Rate for Payer: Vantage Medical Group Senior |
$1,770.57
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
IP
|
$2,083.02
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.60 |
| Max. Negotiated Rate |
$1,874.72 |
| Rate for Payer: Adventist Health Commercial |
$416.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,670.58
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.84
|
| Rate for Payer: Cash Price |
$937.36
|
| Rate for Payer: Central Health Plan Commercial |
$1,666.42
|
| Rate for Payer: Cigna of CA HMO |
$1,458.11
|
| Rate for Payer: Cigna of CA PPO |
$1,458.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,458.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$833.21
|
| Rate for Payer: EPIC Health Plan Senior |
$833.21
|
| Rate for Payer: Galaxy Health WC |
$1,770.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1,249.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,874.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,322.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,228.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.60
|
| Rate for Payer: Multiplan Commercial |
$1,562.27
|
| Rate for Payer: Networks By Design Commercial |
$1,041.51
|
| Rate for Payer: Prime Health Services Commercial |
$1,770.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.76
|
| Rate for Payer: United Healthcare All Other HMO |
$760.93
|
| Rate for Payer: United Healthcare HMO Rider |
$744.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.19
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
OP
|
$1,276.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.34 |
| Max. Negotiated Rate |
$1,149.01 |
| Rate for Payer: Adventist Health Commercial |
$255.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$702.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$957.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$582.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$700.13
|
| Rate for Payer: Blue Shield of California Commercial |
$1,023.90
|
| Rate for Payer: Blue Shield of California EPN |
$643.45
|
| Rate for Payer: Cash Price |
$574.51
|
| Rate for Payer: Central Health Plan Commercial |
$1,021.34
|
| Rate for Payer: Cigna of CA HMO |
$893.68
|
| Rate for Payer: Cigna of CA PPO |
$893.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,085.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,085.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$893.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.67
|
| Rate for Payer: EPIC Health Plan Senior |
$510.67
|
| Rate for Payer: Galaxy Health WC |
$1,085.18
|
| Rate for Payer: Global Benefits Group Commercial |
$766.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$810.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$463.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$753.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$893.68
|
| Rate for Payer: Multiplan Commercial |
$957.51
|
| Rate for Payer: Networks By Design Commercial |
$638.34
|
| Rate for Payer: Prime Health Services Commercial |
$1,085.18
|
| Rate for Payer: Riverside University Health System MISP |
$510.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$766.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$766.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.14
|
| Rate for Payer: United Healthcare All Other HMO |
$466.37
|
| Rate for Payer: United Healthcare HMO Rider |
$456.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,085.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,085.18
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
IP
|
$1,276.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.34 |
| Max. Negotiated Rate |
$1,149.01 |
| Rate for Payer: Adventist Health Commercial |
$255.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,023.90
|
| Rate for Payer: Blue Shield of California EPN |
$643.45
|
| Rate for Payer: Cash Price |
$574.51
|
| Rate for Payer: Central Health Plan Commercial |
$1,021.34
|
| Rate for Payer: Cigna of CA HMO |
$893.68
|
| Rate for Payer: Cigna of CA PPO |
$893.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$893.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.67
|
| Rate for Payer: EPIC Health Plan Senior |
$510.67
|
| Rate for Payer: Galaxy Health WC |
$1,085.18
|
| Rate for Payer: Global Benefits Group Commercial |
$766.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$810.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$753.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.34
|
| Rate for Payer: Multiplan Commercial |
$957.51
|
| Rate for Payer: Networks By Design Commercial |
$638.34
|
| Rate for Payer: Prime Health Services Commercial |
$1,085.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.14
|
| Rate for Payer: United Healthcare All Other HMO |
$466.37
|
| Rate for Payer: United Healthcare HMO Rider |
$456.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.11
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.94
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
IP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.61
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
OP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.88
|
| Rate for Payer: Blue Shield of California Commercial |
$14.04
|
| Rate for Payer: Blue Shield of California EPN |
$8.83
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$16.61
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Riverside University Health System MISP |
$8.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.79
|
| Rate for Payer: Blue Shield of California Commercial |
$15.03
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Cigna of CA HMO |
$15.17
|
| Rate for Payer: Cigna of CA PPO |
$17.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.59
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO |
$11.85
|
| Rate for Payer: United Healthcare HMO Rider |
$11.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.14
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
IP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,806.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,453.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,208.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
OP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Adventist Health Commercial |
$1,087.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,990.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,078.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,633.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,163.28
|
| Rate for Payer: Blue Shield of California Commercial |
$3,447.69
|
| Rate for Payer: Blue Shield of California EPN |
$2,169.76
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: Cigna of CA HMO |
$3,480.32
|
| Rate for Payer: Cigna of CA PPO |
$4,024.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,622.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,622.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,806.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,453.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,973.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,208.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,806.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,175.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,262.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,262.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,719.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Senior |
$4,622.30
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
OP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$112.04 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.42
|
| Rate for Payer: Blue Shield of California Commercial |
$78.93
|
| Rate for Payer: Blue Shield of California EPN |
$49.67
|
| Rate for Payer: Cash Price |
$56.02
|
| Rate for Payer: Central Health Plan Commercial |
$99.59
|
| Rate for Payer: Cigna of CA HMO |
$79.67
|
| Rate for Payer: Cigna of CA PPO |
$92.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$105.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$105.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$87.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$73.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$87.14
|
| Rate for Payer: Multiplan Commercial |
$93.37
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
| Rate for Payer: Riverside University Health System MISP |
$49.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.24
|
| Rate for Payer: United Healthcare All Other HMO |
$62.24
|
| Rate for Payer: United Healthcare HMO Rider |
$62.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$105.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.82
|
| Rate for Payer: Vantage Medical Group Senior |
$105.82
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
IP
|
$124.49
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$112.04 |
| Rate for Payer: Adventist Health Commercial |
$24.90
|
| Rate for Payer: Cash Price |
$56.02
|
| Rate for Payer: Central Health Plan Commercial |
$99.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$87.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.80
|
| Rate for Payer: EPIC Health Plan Senior |
$49.80
|
| Rate for Payer: Galaxy Health WC |
$105.82
|
| Rate for Payer: Global Benefits Group Commercial |
$74.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$73.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.90
|
| Rate for Payer: Multiplan Commercial |
$93.37
|
| Rate for Payer: Networks By Design Commercial |
$80.92
|
| Rate for Payer: Prime Health Services Commercial |
$105.82
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
IP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
|
|
HC CATH PUREWICK FEMALE EXTERNAL
|
Facility
|
OP
|
$65.03
|
|
| Hospital Charge Code |
901608020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Adventist Health Commercial |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.83
|
| Rate for Payer: Blue Shield of California Commercial |
$41.23
|
| Rate for Payer: Blue Shield of California EPN |
$25.95
|
| Rate for Payer: Cash Price |
$29.26
|
| Rate for Payer: Central Health Plan Commercial |
$52.02
|
| Rate for Payer: Cigna of CA HMO |
$41.62
|
| Rate for Payer: Cigna of CA PPO |
$48.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26.01
|
| Rate for Payer: Galaxy Health WC |
$55.28
|
| Rate for Payer: Global Benefits Group Commercial |
$39.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45.52
|
| Rate for Payer: Multiplan Commercial |
$48.77
|
| Rate for Payer: Networks By Design Commercial |
$42.27
|
| Rate for Payer: Prime Health Services Commercial |
$55.28
|
| Rate for Payer: Riverside University Health System MISP |
$26.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.52
|
| Rate for Payer: United Healthcare All Other HMO |
$32.52
|
| Rate for Payer: United Healthcare HMO Rider |
$32.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.28
|
| Rate for Payer: Vantage Medical Group Senior |
$55.28
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
IP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Blue Shield of California Commercial |
$1,057.25
|
| Rate for Payer: Blue Shield of California EPN |
$664.41
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$922.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$837.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$777.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
|
|
HC CATH PWR PICC 4.5FR 55CM
|
Facility
|
OP
|
$1,318.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.65 |
| Max. Negotiated Rate |
$1,186.44 |
| Rate for Payer: Adventist Health Commercial |
$263.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$725.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$988.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$601.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$722.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,057.25
|
| Rate for Payer: Blue Shield of California EPN |
$664.41
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Central Health Plan Commercial |
$1,054.62
|
| Rate for Payer: Cigna of CA HMO |
$922.79
|
| Rate for Payer: Cigna of CA PPO |
$922.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,120.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,120.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$922.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$527.31
|
| Rate for Payer: EPIC Health Plan Senior |
$527.31
|
| Rate for Payer: Galaxy Health WC |
$1,120.53
|
| Rate for Payer: Global Benefits Group Commercial |
$790.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,186.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$837.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$478.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$777.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$922.79
|
| Rate for Payer: Multiplan Commercial |
$988.70
|
| Rate for Payer: Networks By Design Commercial |
$659.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,120.53
|
| Rate for Payer: Riverside University Health System MISP |
$527.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$790.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$790.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.75
|
| Rate for Payer: United Healthcare All Other HMO |
$481.56
|
| Rate for Payer: United Healthcare HMO Rider |
$471.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$431.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,120.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1,120.53
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
OP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$265.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$220.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$264.54
|
| Rate for Payer: Blue Shield of California Commercial |
$386.88
|
| Rate for Payer: Blue Shield of California EPN |
$243.12
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$410.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$284.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$337.67
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: Riverside University Health System MISP |
$192.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.03
|
| Rate for Payer: Vantage Medical Group Senior |
$410.03
|
|
|
HC CATH PWR PICC TRAY 3FR SL
|
Facility
|
IP
|
$482.39
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.48 |
| Max. Negotiated Rate |
$434.15 |
| Rate for Payer: Adventist Health Commercial |
$96.48
|
| Rate for Payer: Blue Shield of California Commercial |
$386.88
|
| Rate for Payer: Blue Shield of California EPN |
$243.12
|
| Rate for Payer: Cash Price |
$217.08
|
| Rate for Payer: Central Health Plan Commercial |
$385.91
|
| Rate for Payer: Cigna of CA HMO |
$337.67
|
| Rate for Payer: Cigna of CA PPO |
$337.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$337.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.96
|
| Rate for Payer: EPIC Health Plan Senior |
$192.96
|
| Rate for Payer: Galaxy Health WC |
$410.03
|
| Rate for Payer: Global Benefits Group Commercial |
$289.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$306.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$284.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.48
|
| Rate for Payer: Multiplan Commercial |
$361.79
|
| Rate for Payer: Networks By Design Commercial |
$241.19
|
| Rate for Payer: Prime Health Services Commercial |
$410.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$181.04
|
| Rate for Payer: United Healthcare All Other HMO |
$176.22
|
| Rate for Payer: United Healthcare HMO Rider |
$172.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.98
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.51
|
| Rate for Payer: Blue Shield of California Commercial |
$137.89
|
| Rate for Payer: Blue Shield of California EPN |
$86.78
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: Cigna of CA HMO |
$139.19
|
| Rate for Payer: Cigna of CA PPO |
$160.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$152.24
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
| Rate for Payer: Riverside University Health System MISP |
$87.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.75
|
| Rate for Payer: United Healthcare All Other HMO |
$108.75
|
| Rate for Payer: United Healthcare HMO Rider |
$108.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.87
|
| Rate for Payer: Vantage Medical Group Senior |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
IP
|
$217.49
|
|
| Hospital Charge Code |
901691401
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$195.74 |
| Rate for Payer: Adventist Health Commercial |
$43.50
|
| Rate for Payer: Cash Price |
$97.87
|
| Rate for Payer: Central Health Plan Commercial |
$173.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.00
|
| Rate for Payer: EPIC Health Plan Senior |
$87.00
|
| Rate for Payer: Galaxy Health WC |
$184.87
|
| Rate for Payer: Global Benefits Group Commercial |
$130.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$141.37
|
| Rate for Payer: Prime Health Services Commercial |
$184.87
|
|
|
HC CATH RADIAL ARTERY 20GA
|
Facility
|
OP
|
$94.62
|
|
| Hospital Charge Code |
901605972
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$85.16 |
| Rate for Payer: Adventist Health Commercial |
$18.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$70.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.04
|
| Rate for Payer: Blue Shield of California Commercial |
$59.99
|
| Rate for Payer: Blue Shield of California EPN |
$37.75
|
| Rate for Payer: Cash Price |
$42.58
|
| Rate for Payer: Central Health Plan Commercial |
$75.70
|
| Rate for Payer: Cigna of CA HMO |
$60.56
|
| Rate for Payer: Cigna of CA PPO |
$70.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$80.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.85
|
| Rate for Payer: EPIC Health Plan Senior |
$37.85
|
| Rate for Payer: Galaxy Health WC |
$80.43
|
| Rate for Payer: Global Benefits Group Commercial |
$56.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$66.23
|
| Rate for Payer: Multiplan Commercial |
$70.97
|
| Rate for Payer: Networks By Design Commercial |
$61.50
|
| Rate for Payer: Prime Health Services Commercial |
$80.43
|
| Rate for Payer: Riverside University Health System MISP |
$37.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.31
|
| Rate for Payer: United Healthcare All Other HMO |
$47.31
|
| Rate for Payer: United Healthcare HMO Rider |
$47.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$80.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.43
|
| Rate for Payer: Vantage Medical Group Senior |
$80.43
|
|
