|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Adventist Health Commercial |
$20.52
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Senior |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
OP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$62.06 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.50
|
| Rate for Payer: Blue Shield of California Commercial |
$42.13
|
| Rate for Payer: Blue Shield of California EPN |
$27.52
|
| Rate for Payer: Cash Price |
$37.93
|
| Rate for Payer: Central Health Plan Commercial |
$55.17
|
| Rate for Payer: Cigna of CA HMO |
$44.13
|
| Rate for Payer: Cigna of CA PPO |
$51.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.06
|
| Rate for Payer: InnovAge PACE Commercial |
$34.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.27
|
| Rate for Payer: Multiplan Commercial |
$51.72
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
| Rate for Payer: Riverside University Health System MISP |
$27.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.48
|
| Rate for Payer: United Healthcare All Other HMO |
$34.48
|
| Rate for Payer: United Healthcare HMO Rider |
$34.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.62
|
| Rate for Payer: Vantage Medical Group Senior |
$58.62
|
|
|
HC CATH MESH VERSETTE EXT FEMALE
|
Facility
|
IP
|
$68.96
|
|
| Hospital Charge Code |
901698882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$62.06 |
| Rate for Payer: Adventist Health Commercial |
$13.79
|
| Rate for Payer: Cash Price |
$37.93
|
| Rate for Payer: Central Health Plan Commercial |
$55.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.58
|
| Rate for Payer: EPIC Health Plan Senior |
$27.58
|
| Rate for Payer: Galaxy Health WC |
$58.62
|
| Rate for Payer: Global Benefits Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.79
|
| Rate for Payer: Multiplan Commercial |
$51.72
|
| Rate for Payer: Networks By Design Commercial |
$44.82
|
| Rate for Payer: Prime Health Services Commercial |
$58.62
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 3FR 20CM SL CDC
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
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 MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
IP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.91 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Blue Shield of California Commercial |
$822.74
|
| Rate for Payer: Blue Shield of California EPN |
$536.43
|
| Rate for Payer: Cash Price |
$585.39
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$658.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
OP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.91 |
| Rate for Payer: Adventist Health Commercial |
$212.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$798.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$485.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$589.33
|
| Rate for Payer: Blue Shield of California Commercial |
$822.74
|
| Rate for Payer: Blue Shield of California EPN |
$536.43
|
| Rate for Payer: Cash Price |
$585.39
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$904.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$904.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$904.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Senior |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.91
|
| Rate for Payer: InnovAge PACE Commercial |
$532.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$658.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.04
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Networks By Design Commercial |
$532.17
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: Riverside University Health System MISP |
$425.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$638.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$638.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.45
|
| Rate for Payer: United Healthcare All Other HMO |
$388.81
|
| Rate for Payer: United Healthcare HMO Rider |
$380.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$348.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$904.70
|
| Rate for Payer: Vantage Medical Group Senior |
$904.70
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
IP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Blue Shield of California Commercial |
$562.06
|
| Rate for Payer: Blue Shield of California EPN |
$366.47
|
| Rate for Payer: Cash Price |
$399.92
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$450.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
OP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Adventist Health Commercial |
$145.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$545.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$332.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$402.61
|
| Rate for Payer: Blue Shield of California Commercial |
$562.06
|
| Rate for Payer: Blue Shield of California EPN |
$366.47
|
| Rate for Payer: Cash Price |
$399.92
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$618.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$618.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$618.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Senior |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: InnovAge PACE Commercial |
$363.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$450.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$508.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$508.98
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: Riverside University Health System MISP |
$290.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$436.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.89
|
| Rate for Payer: United Healthcare All Other HMO |
$265.62
|
| Rate for Payer: United Healthcare HMO Rider |
$259.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$238.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$618.05
|
| Rate for Payer: Vantage Medical Group Senior |
$618.05
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
OP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$353.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$428.25
|
| Rate for Payer: Blue Shield of California Commercial |
$597.87
|
| Rate for Payer: Blue Shield of California EPN |
$389.81
|
| Rate for Payer: Cash Price |
$425.39
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: InnovAge PACE Commercial |
$386.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.41
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: Riverside University Health System MISP |
$309.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.42
|
| Rate for Payer: Vantage Medical Group Senior |
$657.42
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
IP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Adventist Health Commercial |
$154.69
|
| Rate for Payer: Blue Shield of California Commercial |
$597.87
|
| Rate for Payer: Blue Shield of California EPN |
$389.81
|
| Rate for Payer: Cash Price |
$425.39
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Senior |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.27
|
| Rate for Payer: United Healthcare All Other HMO |
$282.54
|
| Rate for Payer: United Healthcare HMO Rider |
$276.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.30
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
IP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Blue Shield of California Commercial |
$611.60
|
| Rate for Payer: Blue Shield of California EPN |
$398.76
|
| Rate for Payer: Cash Price |
$435.16
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
|
|
HC CATH MIDLINE KIT 1 LUMEN 4.5FR
|
Facility
|
OP
|
$791.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$712.08 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$361.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.09
|
| Rate for Payer: Blue Shield of California Commercial |
$611.60
|
| Rate for Payer: Blue Shield of California EPN |
$398.76
|
| Rate for Payer: Cash Price |
$435.16
|
| Rate for Payer: Central Health Plan Commercial |
$632.96
|
| Rate for Payer: Cigna of CA HMO |
$553.84
|
| Rate for Payer: Cigna of CA PPO |
$553.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$712.08
|
| Rate for Payer: InnovAge PACE Commercial |
$395.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$553.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$593.40
|
| Rate for Payer: Networks By Design Commercial |
$395.60
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Riverside University Health System MISP |
$316.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.94
|
| Rate for Payer: United Healthcare All Other HMO |
$289.03
|
| Rate for Payer: United Healthcare HMO Rider |
$282.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$259.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
IP
|
$829.89
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.98 |
| Max. Negotiated Rate |
$746.90 |
| Rate for Payer: Adventist Health Commercial |
$165.98
|
| Rate for Payer: Blue Shield of California Commercial |
$641.50
|
| Rate for Payer: Blue Shield of California EPN |
$418.26
|
| Rate for Payer: Cash Price |
$456.44
|
| Rate for Payer: Central Health Plan Commercial |
$663.91
|
| Rate for Payer: Cigna of CA HMO |
$580.92
|
| Rate for Payer: Cigna of CA PPO |
$580.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.96
|
| Rate for Payer: EPIC Health Plan Senior |
$331.96
|
| Rate for Payer: Galaxy Health WC |
$705.41
|
| Rate for Payer: Global Benefits Group Commercial |
$497.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.98
|
| Rate for Payer: Multiplan Commercial |
$622.42
|
| Rate for Payer: Networks By Design Commercial |
$414.94
|
| Rate for Payer: Prime Health Services Commercial |
$705.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$311.46
|
| Rate for Payer: United Healthcare All Other HMO |
$303.16
|
| Rate for Payer: United Healthcare HMO Rider |
$296.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.79
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
OP
|
$829.89
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.98 |
| Max. Negotiated Rate |
$746.90 |
| Rate for Payer: Adventist Health Commercial |
$165.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$705.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$622.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$378.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.51
|
| Rate for Payer: Blue Shield of California Commercial |
$641.50
|
| Rate for Payer: Blue Shield of California EPN |
$418.26
|
| Rate for Payer: Cash Price |
$456.44
|
| Rate for Payer: Central Health Plan Commercial |
$663.91
|
| Rate for Payer: Cigna of CA HMO |
$580.92
|
| Rate for Payer: Cigna of CA PPO |
$580.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$705.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$705.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$705.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.96
|
| Rate for Payer: EPIC Health Plan Senior |
$331.96
|
| Rate for Payer: Galaxy Health WC |
$705.41
|
| Rate for Payer: Global Benefits Group Commercial |
$497.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.90
|
| Rate for Payer: InnovAge PACE Commercial |
$414.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$580.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$580.92
|
| Rate for Payer: Multiplan Commercial |
$622.42
|
| Rate for Payer: Networks By Design Commercial |
$414.94
|
| Rate for Payer: Prime Health Services Commercial |
$705.41
|
| Rate for Payer: Riverside University Health System MISP |
$331.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$497.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$497.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$311.46
|
| Rate for Payer: United Healthcare All Other HMO |
$303.16
|
| Rate for Payer: United Healthcare HMO Rider |
$296.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$705.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$705.41
|
| Rate for Payer: Vantage Medical Group Senior |
$705.41
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
OP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$801.22 |
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$489.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$667.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$406.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$492.93
|
| Rate for Payer: Blue Shield of California Commercial |
$688.16
|
| Rate for Payer: Blue Shield of California EPN |
$448.68
|
| Rate for Payer: Cash Price |
$489.63
|
| Rate for Payer: Central Health Plan Commercial |
$712.19
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$756.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$756.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.22
|
| Rate for Payer: InnovAge PACE Commercial |
$445.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$623.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$623.17
|
| Rate for Payer: Multiplan Commercial |
$667.68
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: Riverside University Health System MISP |
$356.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$534.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$756.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.70
|
| Rate for Payer: Vantage Medical Group Senior |
$756.70
|
|
|
HC CATH MIDLINE KIT 5.5FR X 15CM
|
Facility
|
IP
|
$890.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.05 |
| Max. Negotiated Rate |
$801.22 |
| Rate for Payer: Adventist Health Commercial |
$178.05
|
| Rate for Payer: Blue Shield of California Commercial |
$688.16
|
| Rate for Payer: Blue Shield of California EPN |
$448.68
|
| Rate for Payer: Cash Price |
$489.63
|
| Rate for Payer: Central Health Plan Commercial |
$712.19
|
| Rate for Payer: Cigna of CA HMO |
$623.17
|
| Rate for Payer: Cigna of CA PPO |
$623.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.10
|
| Rate for Payer: EPIC Health Plan Senior |
$356.10
|
| Rate for Payer: Galaxy Health WC |
$756.70
|
| Rate for Payer: Global Benefits Group Commercial |
$534.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.05
|
| Rate for Payer: Multiplan Commercial |
$667.68
|
| Rate for Payer: Networks By Design Commercial |
$445.12
|
| Rate for Payer: Prime Health Services Commercial |
$756.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$334.11
|
| Rate for Payer: United Healthcare All Other HMO |
$325.20
|
| Rate for Payer: United Healthcare HMO Rider |
$318.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.55
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
OP
|
$908.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.70 |
| Max. Negotiated Rate |
$817.65 |
| Rate for Payer: Adventist Health Commercial |
$181.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$681.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$414.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$503.04
|
| Rate for Payer: Blue Shield of California Commercial |
$702.27
|
| Rate for Payer: Blue Shield of California EPN |
$457.88
|
| Rate for Payer: Cash Price |
$499.68
|
| Rate for Payer: Central Health Plan Commercial |
$726.80
|
| Rate for Payer: Cigna of CA HMO |
$635.95
|
| Rate for Payer: Cigna of CA PPO |
$635.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$772.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$772.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$363.40
|
| Rate for Payer: EPIC Health Plan Senior |
$363.40
|
| Rate for Payer: Galaxy Health WC |
$772.23
|
| Rate for Payer: Global Benefits Group Commercial |
$545.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$817.65
|
| Rate for Payer: InnovAge PACE Commercial |
$454.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$605.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$562.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$635.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$635.95
|
| Rate for Payer: Multiplan Commercial |
$681.38
|
| Rate for Payer: Networks By Design Commercial |
$454.25
|
| Rate for Payer: Prime Health Services Commercial |
$772.23
|
| Rate for Payer: Riverside University Health System MISP |
$363.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$545.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$545.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.96
|
| Rate for Payer: United Healthcare All Other HMO |
$331.88
|
| Rate for Payer: United Healthcare HMO Rider |
$324.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$772.23
|
| Rate for Payer: Vantage Medical Group Senior |
$772.23
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
IP
|
$908.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.70 |
| Max. Negotiated Rate |
$817.65 |
| Rate for Payer: Adventist Health Commercial |
$181.70
|
| Rate for Payer: Blue Shield of California Commercial |
$702.27
|
| Rate for Payer: Blue Shield of California EPN |
$457.88
|
| Rate for Payer: Cash Price |
$499.68
|
| Rate for Payer: Central Health Plan Commercial |
$726.80
|
| Rate for Payer: Cigna of CA HMO |
$635.95
|
| Rate for Payer: Cigna of CA PPO |
$635.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$363.40
|
| Rate for Payer: EPIC Health Plan Senior |
$363.40
|
| Rate for Payer: Galaxy Health WC |
$772.23
|
| Rate for Payer: Global Benefits Group Commercial |
$545.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$817.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$605.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$346.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$562.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.70
|
| Rate for Payer: Multiplan Commercial |
$681.38
|
| Rate for Payer: Networks By Design Commercial |
$454.25
|
| Rate for Payer: Prime Health Services Commercial |
$772.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.96
|
| Rate for Payer: United Healthcare All Other HMO |
$331.88
|
| Rate for Payer: United Healthcare HMO Rider |
$324.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.53
|
|
|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
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 MILLAR MICRO TIP SPC-320
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
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 PACING ELECTRODE 5FR
|
Facility
|
OP
|
$1,162.19
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.44 |
| Max. Negotiated Rate |
$1,045.97 |
| Rate for Payer: Adventist Health Commercial |
$232.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$705.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$987.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$639.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$871.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$562.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$682.55
|
| Rate for Payer: Blue Shield of California Commercial |
$710.10
|
| Rate for Payer: Blue Shield of California EPN |
$463.71
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Central Health Plan Commercial |
$929.75
|
| Rate for Payer: Cigna of CA HMO |
$743.80
|
| Rate for Payer: Cigna of CA PPO |
$860.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$987.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$987.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$987.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.88
|
| Rate for Payer: EPIC Health Plan Senior |
$464.88
|
| Rate for Payer: Galaxy Health WC |
$987.86
|
| Rate for Payer: Global Benefits Group Commercial |
$697.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,045.97
|
| Rate for Payer: InnovAge PACE Commercial |
$581.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$719.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$813.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$813.53
|
| Rate for Payer: Multiplan Commercial |
$871.64
|
| Rate for Payer: Networks By Design Commercial |
$755.42
|
| Rate for Payer: Prime Health Services Commercial |
$987.86
|
| Rate for Payer: Riverside University Health System MISP |
$464.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$697.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$697.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$581.10
|
| Rate for Payer: United Healthcare All Other HMO |
$581.10
|
| Rate for Payer: United Healthcare HMO Rider |
$581.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$987.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$987.86
|
| Rate for Payer: Vantage Medical Group Senior |
$987.86
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
IP
|
$1,162.19
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.44 |
| Max. Negotiated Rate |
$1,045.97 |
| Rate for Payer: Adventist Health Commercial |
$232.44
|
| Rate for Payer: Cash Price |
$639.20
|
| Rate for Payer: Central Health Plan Commercial |
$929.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.88
|
| Rate for Payer: EPIC Health Plan Senior |
$464.88
|
| Rate for Payer: Galaxy Health WC |
$987.86
|
| Rate for Payer: Global Benefits Group Commercial |
$697.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,045.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$719.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.44
|
| Rate for Payer: Multiplan Commercial |
$871.64
|
| Rate for Payer: Networks By Design Commercial |
$755.42
|
| Rate for Payer: Prime Health Services Commercial |
$987.86
|
|
|
HC CATH PEDIAVASC MONGOOSE
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.41
|
| Rate for Payer: Blue Shield of California Commercial |
$76.38
|
| Rate for Payer: Blue Shield of California EPN |
$49.88
|
| Rate for Payer: Cash Price |
$68.75
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: InnovAge PACE Commercial |
$62.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.50
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Riverside University Health System MISP |
$50.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.50
|
| Rate for Payer: United Healthcare All Other HMO |
$62.50
|
| Rate for Payer: United Healthcare HMO Rider |
$62.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.25
|
| Rate for Payer: Vantage Medical Group Senior |
$106.25
|
|
|
HC CATH PEDIAVASC MONGOOSE
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$68.75
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
