|
HC CATH HEMODIALYSIS SHORT-TERM
|
Facility
|
IP
|
$376.24
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
909081449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.25 |
| Max. Negotiated Rate |
$338.62 |
| Rate for Payer: Adventist Health Commercial |
$75.25
|
| Rate for Payer: Blue Shield of California Commercial |
$290.83
|
| Rate for Payer: Blue Shield of California EPN |
$189.62
|
| Rate for Payer: Cash Price |
$206.93
|
| Rate for Payer: Central Health Plan Commercial |
$300.99
|
| Rate for Payer: Cigna of CA HMO |
$263.37
|
| Rate for Payer: Cigna of CA PPO |
$263.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.50
|
| Rate for Payer: EPIC Health Plan Senior |
$150.50
|
| Rate for Payer: Galaxy Health WC |
$319.80
|
| Rate for Payer: Global Benefits Group Commercial |
$225.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$338.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$250.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$232.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.25
|
| Rate for Payer: Multiplan Commercial |
$282.18
|
| Rate for Payer: Networks By Design Commercial |
$188.12
|
| Rate for Payer: Prime Health Services Commercial |
$319.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$141.20
|
| Rate for Payer: United Healthcare All Other HMO |
$137.44
|
| Rate for Payer: United Healthcare HMO Rider |
$134.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.22
|
|
|
HC CATH HEMODIALYSIS SHORT-TERM
|
Facility
|
OP
|
$376.24
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
909081449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.25 |
| Max. Negotiated Rate |
$338.62 |
| Rate for Payer: Adventist Health Commercial |
$75.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$319.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$206.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$171.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$208.32
|
| Rate for Payer: Blue Shield of California Commercial |
$290.83
|
| Rate for Payer: Blue Shield of California EPN |
$189.62
|
| Rate for Payer: Cash Price |
$206.93
|
| Rate for Payer: Central Health Plan Commercial |
$300.99
|
| Rate for Payer: Cigna of CA HMO |
$263.37
|
| Rate for Payer: Cigna of CA PPO |
$263.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$319.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$319.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$319.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.50
|
| Rate for Payer: EPIC Health Plan Senior |
$150.50
|
| Rate for Payer: Galaxy Health WC |
$319.80
|
| Rate for Payer: Global Benefits Group Commercial |
$225.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$338.62
|
| Rate for Payer: InnovAge PACE Commercial |
$188.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$250.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$232.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.37
|
| Rate for Payer: Multiplan Commercial |
$282.18
|
| Rate for Payer: Networks By Design Commercial |
$188.12
|
| Rate for Payer: Prime Health Services Commercial |
$319.80
|
| Rate for Payer: Riverside University Health System MISP |
$150.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$225.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$141.20
|
| Rate for Payer: United Healthcare All Other HMO |
$137.44
|
| Rate for Payer: United Healthcare HMO Rider |
$134.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$319.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$319.80
|
| Rate for Payer: Vantage Medical Group Senior |
$319.80
|
|
|
HC CATH HEMO KIT 12FRX16CM UBEND
|
Facility
|
IP
|
$895.85
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.17 |
| Max. Negotiated Rate |
$806.26 |
| Rate for Payer: Adventist Health Commercial |
$179.17
|
| Rate for Payer: Blue Shield of California Commercial |
$692.49
|
| Rate for Payer: Blue Shield of California EPN |
$451.51
|
| Rate for Payer: Cash Price |
$492.72
|
| Rate for Payer: Central Health Plan Commercial |
$716.68
|
| Rate for Payer: Cigna of CA HMO |
$627.10
|
| Rate for Payer: Cigna of CA PPO |
$627.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.34
|
| Rate for Payer: EPIC Health Plan Senior |
$358.34
|
| Rate for Payer: Galaxy Health WC |
$761.47
|
| Rate for Payer: Global Benefits Group Commercial |
$537.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$806.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$597.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$554.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.17
|
| Rate for Payer: Multiplan Commercial |
$671.89
|
| Rate for Payer: Networks By Design Commercial |
$447.93
|
| Rate for Payer: Prime Health Services Commercial |
$761.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$336.21
|
| Rate for Payer: United Healthcare All Other HMO |
$327.25
|
| Rate for Payer: United Healthcare HMO Rider |
$320.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$293.39
|
|
|
HC CATH HEMO KIT 12FRX16CM UBEND
|
Facility
|
OP
|
$895.85
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.17 |
| Max. Negotiated Rate |
$806.26 |
| Rate for Payer: Adventist Health Commercial |
$179.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$492.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$671.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$409.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$496.03
|
| Rate for Payer: Blue Shield of California Commercial |
$692.49
|
| Rate for Payer: Blue Shield of California EPN |
$451.51
|
| Rate for Payer: Cash Price |
$492.72
|
| Rate for Payer: Central Health Plan Commercial |
$716.68
|
| Rate for Payer: Cigna of CA HMO |
$627.10
|
| Rate for Payer: Cigna of CA PPO |
$627.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$761.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$761.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.34
|
| Rate for Payer: EPIC Health Plan Senior |
$358.34
|
| Rate for Payer: Galaxy Health WC |
$761.47
|
| Rate for Payer: Global Benefits Group Commercial |
$537.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$806.26
|
| Rate for Payer: InnovAge PACE Commercial |
$447.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$597.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$554.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.10
|
| Rate for Payer: Multiplan Commercial |
$671.89
|
| Rate for Payer: Networks By Design Commercial |
$447.93
|
| Rate for Payer: Prime Health Services Commercial |
$761.47
|
| Rate for Payer: Riverside University Health System MISP |
$358.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$537.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$537.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$336.21
|
| Rate for Payer: United Healthcare All Other HMO |
$327.25
|
| Rate for Payer: United Healthcare HMO Rider |
$320.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$293.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$761.47
|
| Rate for Payer: Vantage Medical Group Senior |
$761.47
|
|
|
HC CATH HEMO KIT 12FRX20CM UBEND
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.10
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: InnovAge PACE Commercial |
$129.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Riverside University Health System MISP |
$103.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO KIT 12FRX20CM UBEND
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.10
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: InnovAge PACE Commercial |
$129.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Riverside University Health System MISP |
$103.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.10
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: InnovAge PACE Commercial |
$129.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Riverside University Health System MISP |
$103.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX25CM
|
Facility
|
IP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
|
|
HC CATH HEMO KIT 2LUMEN 12FRX25CM
|
Facility
|
OP
|
$258.44
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.69 |
| Max. Negotiated Rate |
$232.60 |
| Rate for Payer: Adventist Health Commercial |
$51.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.10
|
| Rate for Payer: Blue Shield of California Commercial |
$199.77
|
| Rate for Payer: Blue Shield of California EPN |
$130.25
|
| Rate for Payer: Cash Price |
$142.14
|
| Rate for Payer: Central Health Plan Commercial |
$206.75
|
| Rate for Payer: Cigna of CA HMO |
$180.91
|
| Rate for Payer: Cigna of CA PPO |
$180.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.38
|
| Rate for Payer: EPIC Health Plan Senior |
$103.38
|
| Rate for Payer: Galaxy Health WC |
$219.67
|
| Rate for Payer: Global Benefits Group Commercial |
$155.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.60
|
| Rate for Payer: InnovAge PACE Commercial |
$129.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.91
|
| Rate for Payer: Multiplan Commercial |
$193.83
|
| Rate for Payer: Networks By Design Commercial |
$129.22
|
| Rate for Payer: Prime Health Services Commercial |
$219.67
|
| Rate for Payer: Riverside University Health System MISP |
$103.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.99
|
| Rate for Payer: United Healthcare All Other HMO |
$94.41
|
| Rate for Payer: United Healthcare HMO Rider |
$92.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.67
|
| Rate for Payer: Vantage Medical Group Senior |
$219.67
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
|
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$305.16
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: InnovAge PACE Commercial |
$275.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.78
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health System MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
|
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
|
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$305.16
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: InnovAge PACE Commercial |
$275.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$385.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$385.78
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health System MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
|
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Adventist Health Commercial |
$110.22
|
| Rate for Payer: Blue Shield of California Commercial |
$426.02
|
| Rate for Payer: Blue Shield of California EPN |
$277.76
|
| Rate for Payer: Cash Price |
$303.12
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Senior |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.84
|
| Rate for Payer: United Healthcare All Other HMO |
$201.32
|
| Rate for Payer: United Healthcare HMO Rider |
$196.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$180.49
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH HICKMAN 7FR
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,350.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,405.30
|
| Rate for Payer: Blue Shield of California EPN |
$917.70
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,050.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,273.51
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,777.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,265.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
OP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$396.77 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$201.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.10
|
| Rate for Payer: Blue Shield of California Commercial |
$340.78
|
| Rate for Payer: Blue Shield of California EPN |
$222.19
|
| Rate for Payer: Cash Price |
$242.47
|
| Rate for Payer: Central Health Plan Commercial |
$352.69
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.77
|
| Rate for Payer: InnovAge PACE Commercial |
$220.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.60
|
| Rate for Payer: Multiplan Commercial |
$330.64
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: Riverside University Health System MISP |
$176.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.73
|
| Rate for Payer: Vantage Medical Group Senior |
$374.73
|
|
