|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC DUAL LUMEN 1.9FR
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
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 PICC INS TRAY NEONATAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$213.85
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC INS TRAY NEONATAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
IP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$852.01 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Blue Shield of California Commercial |
$731.78
|
| Rate for Payer: Blue Shield of California EPN |
$477.13
|
| Rate for Payer: Cash Price |
$520.67
|
| Rate for Payer: Central Health Plan Commercial |
$757.34
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$852.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$631.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$585.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.34
|
| Rate for Payer: Multiplan Commercial |
$710.01
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
OP
|
$946.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.34 |
| Max. Negotiated Rate |
$852.01 |
| Rate for Payer: Adventist Health Commercial |
$189.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$520.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$710.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$432.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$524.18
|
| Rate for Payer: Blue Shield of California Commercial |
$731.78
|
| Rate for Payer: Blue Shield of California EPN |
$477.13
|
| Rate for Payer: Cash Price |
$520.67
|
| Rate for Payer: Central Health Plan Commercial |
$757.34
|
| Rate for Payer: Cigna of CA HMO |
$662.68
|
| Rate for Payer: Cigna of CA PPO |
$662.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$804.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$804.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$804.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$378.67
|
| Rate for Payer: EPIC Health Plan Senior |
$378.67
|
| Rate for Payer: Galaxy Health WC |
$804.68
|
| Rate for Payer: Global Benefits Group Commercial |
$568.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$852.01
|
| Rate for Payer: InnovAge PACE Commercial |
$473.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$631.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$360.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$585.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$662.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$662.68
|
| Rate for Payer: Multiplan Commercial |
$710.01
|
| Rate for Payer: Networks By Design Commercial |
$473.34
|
| Rate for Payer: Prime Health Services Commercial |
$804.68
|
| Rate for Payer: Riverside University Health System MISP |
$378.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$568.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$568.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.29
|
| Rate for Payer: United Healthcare All Other HMO |
$345.82
|
| Rate for Payer: United Healthcare HMO Rider |
$338.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$804.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$804.68
|
| Rate for Payer: Vantage Medical Group Senior |
$804.68
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
IP
|
$1,658.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.62 |
| Max. Negotiated Rate |
$1,492.31 |
| Rate for Payer: Adventist Health Commercial |
$331.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,281.73
|
| Rate for Payer: Blue Shield of California EPN |
$835.69
|
| Rate for Payer: Cash Price |
$911.97
|
| Rate for Payer: Central Health Plan Commercial |
$1,326.50
|
| Rate for Payer: Cigna of CA HMO |
$1,160.68
|
| Rate for Payer: Cigna of CA PPO |
$1,160.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$663.25
|
| Rate for Payer: EPIC Health Plan Senior |
$663.25
|
| Rate for Payer: Galaxy Health WC |
$1,409.40
|
| Rate for Payer: Global Benefits Group Commercial |
$994.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,492.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,105.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$631.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,026.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.62
|
| Rate for Payer: Multiplan Commercial |
$1,243.59
|
| Rate for Payer: Networks By Design Commercial |
$829.06
|
| Rate for Payer: Prime Health Services Commercial |
$1,409.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$622.29
|
| Rate for Payer: United Healthcare All Other HMO |
$605.71
|
| Rate for Payer: United Healthcare HMO Rider |
$592.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$543.03
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
OP
|
$1,658.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.62 |
| Max. Negotiated Rate |
$1,492.31 |
| Rate for Payer: Adventist Health Commercial |
$331.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$911.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,243.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$757.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$918.10
|
| Rate for Payer: Blue Shield of California Commercial |
$1,281.73
|
| Rate for Payer: Blue Shield of California EPN |
$835.69
|
| Rate for Payer: Cash Price |
$911.97
|
| Rate for Payer: Central Health Plan Commercial |
$1,326.50
|
| Rate for Payer: Cigna of CA HMO |
$1,160.68
|
| Rate for Payer: Cigna of CA PPO |
$1,160.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,409.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,409.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$663.25
|
| Rate for Payer: EPIC Health Plan Senior |
$663.25
|
| Rate for Payer: Galaxy Health WC |
$1,409.40
|
| Rate for Payer: Global Benefits Group Commercial |
$994.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,492.31
|
| Rate for Payer: InnovAge PACE Commercial |
$829.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,105.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$631.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,026.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,160.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,160.68
|
| Rate for Payer: Multiplan Commercial |
$1,243.59
|
| Rate for Payer: Networks By Design Commercial |
$829.06
|
| Rate for Payer: Prime Health Services Commercial |
$1,409.40
|
| Rate for Payer: Riverside University Health System MISP |
$663.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$994.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$994.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$622.29
|
| Rate for Payer: United Healthcare All Other HMO |
$605.71
|
| Rate for Payer: United Healthcare HMO Rider |
$592.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$543.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,409.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,409.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,409.40
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
OP
|
$386.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Adventist Health Commercial |
$77.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$289.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$176.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$213.79
|
| Rate for Payer: Blue Shield of California Commercial |
$298.46
|
| Rate for Payer: Blue Shield of California EPN |
$194.60
|
| Rate for Payer: Cash Price |
$212.36
|
| Rate for Payer: Central Health Plan Commercial |
$308.89
|
| Rate for Payer: Cigna of CA HMO |
$270.28
|
| Rate for Payer: Cigna of CA PPO |
$270.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$328.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$328.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.44
|
| Rate for Payer: EPIC Health Plan Senior |
$154.44
|
| Rate for Payer: Galaxy Health WC |
$328.19
|
| Rate for Payer: Global Benefits Group Commercial |
$231.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$347.50
|
| Rate for Payer: InnovAge PACE Commercial |
$193.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$257.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$270.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$270.28
|
| Rate for Payer: Multiplan Commercial |
$289.58
|
| Rate for Payer: Networks By Design Commercial |
$193.06
|
| Rate for Payer: Prime Health Services Commercial |
$328.19
|
| Rate for Payer: Riverside University Health System MISP |
$154.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.91
|
| Rate for Payer: United Healthcare All Other HMO |
$141.05
|
| Rate for Payer: United Healthcare HMO Rider |
$138.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$328.19
|
| Rate for Payer: Vantage Medical Group Senior |
$328.19
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
IP
|
$386.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Adventist Health Commercial |
$77.22
|
| Rate for Payer: Blue Shield of California Commercial |
$298.46
|
| Rate for Payer: Blue Shield of California EPN |
$194.60
|
| Rate for Payer: Cash Price |
$212.36
|
| Rate for Payer: Central Health Plan Commercial |
$308.89
|
| Rate for Payer: Cigna of CA HMO |
$270.28
|
| Rate for Payer: Cigna of CA PPO |
$270.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.44
|
| Rate for Payer: EPIC Health Plan Senior |
$154.44
|
| Rate for Payer: Galaxy Health WC |
$328.19
|
| Rate for Payer: Global Benefits Group Commercial |
$231.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$347.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$257.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$239.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.22
|
| Rate for Payer: Multiplan Commercial |
$289.58
|
| Rate for Payer: Networks By Design Commercial |
$193.06
|
| Rate for Payer: Prime Health Services Commercial |
$328.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.91
|
| Rate for Payer: United Healthcare All Other HMO |
$141.05
|
| Rate for Payer: United Healthcare HMO Rider |
$138.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.45
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
OP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$325.41 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$198.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$271.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$200.20
|
| Rate for Payer: Blue Shield of California Commercial |
$279.49
|
| Rate for Payer: Blue Shield of California EPN |
$182.23
|
| Rate for Payer: Cash Price |
$198.86
|
| Rate for Payer: Central Health Plan Commercial |
$289.26
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$307.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$307.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$325.41
|
| Rate for Payer: InnovAge PACE Commercial |
$180.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$223.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$253.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$253.10
|
| Rate for Payer: Multiplan Commercial |
$271.18
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: Riverside University Health System MISP |
$144.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$216.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$216.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$307.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$307.33
|
| Rate for Payer: Vantage Medical Group Senior |
$307.33
|
|
|
HC CATH PICC POLY 1.9FR 1 LUMEN
|
Facility
|
IP
|
$361.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$325.41 |
| Rate for Payer: Adventist Health Commercial |
$72.31
|
| Rate for Payer: Blue Shield of California Commercial |
$279.49
|
| Rate for Payer: Blue Shield of California EPN |
$182.23
|
| Rate for Payer: Cash Price |
$198.86
|
| Rate for Payer: Central Health Plan Commercial |
$289.26
|
| Rate for Payer: Cigna of CA HMO |
$253.10
|
| Rate for Payer: Cigna of CA PPO |
$253.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$144.63
|
| Rate for Payer: EPIC Health Plan Senior |
$144.63
|
| Rate for Payer: Galaxy Health WC |
$307.33
|
| Rate for Payer: Global Benefits Group Commercial |
$216.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$325.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$241.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$223.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.31
|
| Rate for Payer: Multiplan Commercial |
$271.18
|
| Rate for Payer: Networks By Design Commercial |
$180.78
|
| Rate for Payer: Prime Health Services Commercial |
$307.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.70
|
| Rate for Payer: United Healthcare All Other HMO |
$132.08
|
| Rate for Payer: United Healthcare HMO Rider |
$129.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.41
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
IP
|
$393.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.69 |
| Max. Negotiated Rate |
$354.12 |
| Rate for Payer: Adventist Health Commercial |
$78.69
|
| Rate for Payer: Blue Shield of California Commercial |
$304.15
|
| Rate for Payer: Blue Shield of California EPN |
$198.31
|
| Rate for Payer: Cash Price |
$216.41
|
| Rate for Payer: Central Health Plan Commercial |
$314.78
|
| Rate for Payer: Cigna of CA HMO |
$275.43
|
| Rate for Payer: Cigna of CA PPO |
$275.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.39
|
| Rate for Payer: EPIC Health Plan Senior |
$157.39
|
| Rate for Payer: Galaxy Health WC |
$334.45
|
| Rate for Payer: Global Benefits Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.69
|
| Rate for Payer: Multiplan Commercial |
$295.10
|
| Rate for Payer: Networks By Design Commercial |
$196.74
|
| Rate for Payer: Prime Health Services Commercial |
$334.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.67
|
| Rate for Payer: United Healthcare All Other HMO |
$143.73
|
| Rate for Payer: United Healthcare HMO Rider |
$140.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.86
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
OP
|
$393.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.69 |
| Max. Negotiated Rate |
$354.12 |
| Rate for Payer: Adventist Health Commercial |
$78.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.86
|
| Rate for Payer: Blue Shield of California Commercial |
$304.15
|
| Rate for Payer: Blue Shield of California EPN |
$198.31
|
| Rate for Payer: Cash Price |
$216.41
|
| Rate for Payer: Central Health Plan Commercial |
$314.78
|
| Rate for Payer: Cigna of CA HMO |
$275.43
|
| Rate for Payer: Cigna of CA PPO |
$275.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.39
|
| Rate for Payer: EPIC Health Plan Senior |
$157.39
|
| Rate for Payer: Galaxy Health WC |
$334.45
|
| Rate for Payer: Global Benefits Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.12
|
| Rate for Payer: InnovAge PACE Commercial |
$196.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.43
|
| Rate for Payer: Multiplan Commercial |
$295.10
|
| Rate for Payer: Networks By Design Commercial |
$196.74
|
| Rate for Payer: Prime Health Services Commercial |
$334.45
|
| Rate for Payer: Riverside University Health System MISP |
$157.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.67
|
| Rate for Payer: United Healthcare All Other HMO |
$143.73
|
| Rate for Payer: United Healthcare HMO Rider |
$140.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.45
|
| Rate for Payer: Vantage Medical Group Senior |
$334.45
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$642.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$876.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$533.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$646.94
|
| Rate for Payer: Blue Shield of California Commercial |
$903.17
|
| Rate for Payer: Blue Shield of California EPN |
$588.87
|
| Rate for Payer: Cash Price |
$642.62
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$993.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$993.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$993.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: InnovAge PACE Commercial |
$584.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$723.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$817.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$817.88
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: Riverside University Health System MISP |
$467.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$701.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$701.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$993.14
|
| Rate for Payer: Vantage Medical Group Senior |
$993.14
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Adventist Health Commercial |
$233.68
|
| Rate for Payer: Blue Shield of California Commercial |
$903.17
|
| Rate for Payer: Blue Shield of California EPN |
$588.87
|
| Rate for Payer: Cash Price |
$642.62
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Senior |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$723.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$438.50
|
| Rate for Payer: United Healthcare All Other HMO |
$426.82
|
| Rate for Payer: United Healthcare HMO Rider |
$417.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$382.65
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
IP
|
$1,095.81
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.16 |
| Max. Negotiated Rate |
$986.23 |
| Rate for Payer: Adventist Health Commercial |
$219.16
|
| Rate for Payer: Blue Shield of California Commercial |
$847.06
|
| Rate for Payer: Blue Shield of California EPN |
$552.29
|
| Rate for Payer: Cash Price |
$602.70
|
| Rate for Payer: Central Health Plan Commercial |
$876.65
|
| Rate for Payer: Cigna of CA HMO |
$767.07
|
| Rate for Payer: Cigna of CA PPO |
$767.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.32
|
| Rate for Payer: EPIC Health Plan Senior |
$438.32
|
| Rate for Payer: Galaxy Health WC |
$931.44
|
| Rate for Payer: Global Benefits Group Commercial |
$657.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$986.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$678.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.16
|
| Rate for Payer: Multiplan Commercial |
$821.86
|
| Rate for Payer: Networks By Design Commercial |
$547.90
|
| Rate for Payer: Prime Health Services Commercial |
$931.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$411.26
|
| Rate for Payer: United Healthcare All Other HMO |
$400.30
|
| Rate for Payer: United Healthcare HMO Rider |
$391.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$358.88
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
OP
|
$1,095.81
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.16 |
| Max. Negotiated Rate |
$986.23 |
| Rate for Payer: Adventist Health Commercial |
$219.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$931.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$602.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$821.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$500.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$606.75
|
| Rate for Payer: Blue Shield of California Commercial |
$847.06
|
| Rate for Payer: Blue Shield of California EPN |
$552.29
|
| Rate for Payer: Cash Price |
$602.70
|
| Rate for Payer: Central Health Plan Commercial |
$876.65
|
| Rate for Payer: Cigna of CA HMO |
$767.07
|
| Rate for Payer: Cigna of CA PPO |
$767.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$931.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$931.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$931.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.32
|
| Rate for Payer: EPIC Health Plan Senior |
$438.32
|
| Rate for Payer: Galaxy Health WC |
$931.44
|
| Rate for Payer: Global Benefits Group Commercial |
$657.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$986.23
|
| Rate for Payer: InnovAge PACE Commercial |
$547.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$678.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$767.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$767.07
|
| Rate for Payer: Multiplan Commercial |
$821.86
|
| Rate for Payer: Networks By Design Commercial |
$547.90
|
| Rate for Payer: Prime Health Services Commercial |
$931.44
|
| Rate for Payer: Riverside University Health System MISP |
$438.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$657.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$411.26
|
| Rate for Payer: United Healthcare All Other HMO |
$400.30
|
| Rate for Payer: United Healthcare HMO Rider |
$391.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$358.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$931.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$931.44
|
| Rate for Payer: Vantage Medical Group Senior |
$931.44
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
OP
|
$2,081.59
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.32 |
| Max. Negotiated Rate |
$1,873.43 |
| Rate for Payer: Adventist Health Commercial |
$416.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,769.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,144.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,561.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$950.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,152.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,609.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.12
|
| Rate for Payer: Cash Price |
$1,144.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,665.27
|
| Rate for Payer: Cigna of CA HMO |
$1,457.11
|
| Rate for Payer: Cigna of CA PPO |
$1,457.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,769.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,769.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,769.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$832.64
|
| Rate for Payer: EPIC Health Plan Senior |
$832.64
|
| Rate for Payer: Galaxy Health WC |
$1,769.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,248.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,873.43
|
| Rate for Payer: InnovAge PACE Commercial |
$1,040.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,388.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,288.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,457.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,457.11
|
| Rate for Payer: Multiplan Commercial |
$1,561.19
|
| Rate for Payer: Networks By Design Commercial |
$1,040.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,769.35
|
| Rate for Payer: Riverside University Health System MISP |
$832.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,248.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,248.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.22
|
| Rate for Payer: United Healthcare All Other HMO |
$760.40
|
| Rate for Payer: United Healthcare HMO Rider |
$743.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$681.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,769.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,769.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,769.35
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
IP
|
$2,081.59
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.32 |
| Max. Negotiated Rate |
$1,873.43 |
| Rate for Payer: Adventist Health Commercial |
$416.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,609.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.12
|
| Rate for Payer: Cash Price |
$1,144.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,665.27
|
| Rate for Payer: Cigna of CA HMO |
$1,457.11
|
| Rate for Payer: Cigna of CA PPO |
$1,457.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$832.64
|
| Rate for Payer: EPIC Health Plan Senior |
$832.64
|
| Rate for Payer: Galaxy Health WC |
$1,769.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,248.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,873.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,388.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,288.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.32
|
| Rate for Payer: Multiplan Commercial |
$1,561.19
|
| Rate for Payer: Networks By Design Commercial |
$1,040.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,769.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.22
|
| Rate for Payer: United Healthcare All Other HMO |
$760.40
|
| Rate for Payer: United Healthcare HMO Rider |
$743.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$681.72
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Blue Shield of California Commercial |
$764.50
|
| Rate for Payer: Blue Shield of California EPN |
$498.46
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$543.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$741.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$451.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$547.61
|
| Rate for Payer: Blue Shield of California Commercial |
$764.50
|
| Rate for Payer: Blue Shield of California EPN |
$498.46
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$840.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$840.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$840.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: InnovAge PACE Commercial |
$494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$692.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$692.30
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Riverside University Health System MISP |
$395.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.17
|
| Rate for Payer: United Healthcare All Other HMO |
$361.28
|
| Rate for Payer: United Healthcare HMO Rider |
$353.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$323.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$840.65
|
| Rate for Payer: Vantage Medical Group Senior |
$840.65
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$962.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$586.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$710.62
|
| Rate for Payer: Blue Shield of California Commercial |
$992.07
|
| Rate for Payer: Blue Shield of California EPN |
$646.83
|
| Rate for Payer: Cash Price |
$705.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,090.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: InnovAge PACE Commercial |
$641.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$898.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$898.38
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Riverside University Health System MISP |
$513.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Adventist Health Commercial |
$256.68
|
| Rate for Payer: Blue Shield of California Commercial |
$992.07
|
| Rate for Payer: Blue Shield of California EPN |
$646.83
|
| Rate for Payer: Cash Price |
$705.87
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Senior |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$794.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$481.66
|
| Rate for Payer: United Healthcare All Other HMO |
$468.83
|
| Rate for Payer: United Healthcare HMO Rider |
$458.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$420.31
|
|
