|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
OP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$1,211.65 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$740.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,009.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$614.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$745.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,040.67
|
| Rate for Payer: Blue Shield of California EPN |
$678.53
|
| Rate for Payer: Cash Price |
$740.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,077.02
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,144.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,144.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,211.65
|
| Rate for Payer: InnovAge PACE Commercial |
$673.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$897.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$833.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$942.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$942.40
|
| Rate for Payer: Multiplan Commercial |
$1,009.71
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: Riverside University Health System MISP |
$538.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$807.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$807.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,144.34
|
| Rate for Payer: Vantage Medical Group Senior |
$1,144.34
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
IP
|
$1,346.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.26 |
| Max. Negotiated Rate |
$1,211.65 |
| Rate for Payer: Adventist Health Commercial |
$269.26
|
| Rate for Payer: Blue Shield of California Commercial |
$1,040.67
|
| Rate for Payer: Blue Shield of California EPN |
$678.53
|
| Rate for Payer: Cash Price |
$740.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,077.02
|
| Rate for Payer: Cigna of CA HMO |
$942.40
|
| Rate for Payer: Cigna of CA PPO |
$942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.51
|
| Rate for Payer: EPIC Health Plan Senior |
$538.51
|
| Rate for Payer: Galaxy Health WC |
$1,144.34
|
| Rate for Payer: Global Benefits Group Commercial |
$807.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,211.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$897.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$833.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.26
|
| Rate for Payer: Multiplan Commercial |
$1,009.71
|
| Rate for Payer: Networks By Design Commercial |
$673.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,144.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$505.26
|
| Rate for Payer: United Healthcare All Other HMO |
$491.80
|
| Rate for Payer: United Healthcare HMO Rider |
$481.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.91
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Blue Shield of California Commercial |
$956.51
|
| Rate for Payer: Blue Shield of California EPN |
$623.65
|
| Rate for Payer: Cash Price |
$680.57
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$565.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$685.15
|
| Rate for Payer: Blue Shield of California Commercial |
$956.51
|
| Rate for Payer: Blue Shield of California EPN |
$623.65
|
| Rate for Payer: Cash Price |
$680.57
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: InnovAge PACE Commercial |
$618.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Riverside University Health System MISP |
$494.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$928.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$565.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$685.15
|
| Rate for Payer: Blue Shield of California Commercial |
$956.51
|
| Rate for Payer: Blue Shield of California EPN |
$623.65
|
| Rate for Payer: Cash Price |
$680.57
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: InnovAge PACE Commercial |
$618.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.18
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Riverside University Health System MISP |
$494.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Adventist Health Commercial |
$247.48
|
| Rate for Payer: Blue Shield of California Commercial |
$956.51
|
| Rate for Payer: Blue Shield of California EPN |
$623.65
|
| Rate for Payer: Cash Price |
$680.57
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Senior |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$765.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$464.40
|
| Rate for Payer: United Healthcare All Other HMO |
$452.02
|
| Rate for Payer: United Healthcare HMO Rider |
$442.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.25
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
OP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,124.68 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$758.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$687.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$937.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$605.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$733.91
|
| Rate for Payer: Blue Shield of California Commercial |
$763.53
|
| Rate for Payer: Blue Shield of California EPN |
$498.61
|
| Rate for Payer: Cash Price |
$687.30
|
| Rate for Payer: Central Health Plan Commercial |
$999.71
|
| Rate for Payer: Cigna of CA HMO |
$799.77
|
| Rate for Payer: Cigna of CA PPO |
$924.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,062.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.68
|
| Rate for Payer: InnovAge PACE Commercial |
$624.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$874.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$874.75
|
| Rate for Payer: Multiplan Commercial |
$937.23
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
| Rate for Payer: Riverside University Health System MISP |
$499.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.82
|
| Rate for Payer: United Healthcare All Other HMO |
$624.82
|
| Rate for Payer: United Healthcare HMO Rider |
$624.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,062.19
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
IP
|
$1,249.64
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.93 |
| Max. Negotiated Rate |
$1,124.68 |
| Rate for Payer: Adventist Health Commercial |
$249.93
|
| Rate for Payer: Cash Price |
$687.30
|
| Rate for Payer: Central Health Plan Commercial |
$999.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.86
|
| Rate for Payer: EPIC Health Plan Senior |
$499.86
|
| Rate for Payer: Galaxy Health WC |
$1,062.19
|
| Rate for Payer: Global Benefits Group Commercial |
$749.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$773.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.93
|
| Rate for Payer: Multiplan Commercial |
$937.23
|
| Rate for Payer: Networks By Design Commercial |
$812.27
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.19
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
OP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$1,489.99 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$910.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,241.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$755.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$916.67
|
| Rate for Payer: Blue Shield of California Commercial |
$1,279.73
|
| Rate for Payer: Blue Shield of California EPN |
$834.39
|
| Rate for Payer: Cash Price |
$910.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,324.43
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,407.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,407.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,489.99
|
| Rate for Payer: InnovAge PACE Commercial |
$827.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,104.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,024.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,158.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,158.88
|
| Rate for Payer: Multiplan Commercial |
$1,241.65
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: Riverside University Health System MISP |
$662.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$993.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$993.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,407.21
|
| Rate for Payer: Vantage Medical Group Senior |
$1,407.21
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
IP
|
$1,655.54
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.11 |
| Max. Negotiated Rate |
$1,489.99 |
| Rate for Payer: Adventist Health Commercial |
$331.11
|
| Rate for Payer: Blue Shield of California Commercial |
$1,279.73
|
| Rate for Payer: Blue Shield of California EPN |
$834.39
|
| Rate for Payer: Cash Price |
$910.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,324.43
|
| Rate for Payer: Cigna of CA HMO |
$1,158.88
|
| Rate for Payer: Cigna of CA PPO |
$1,158.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$662.22
|
| Rate for Payer: EPIC Health Plan Senior |
$662.22
|
| Rate for Payer: Galaxy Health WC |
$1,407.21
|
| Rate for Payer: Global Benefits Group Commercial |
$993.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,489.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,104.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$630.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,024.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.11
|
| Rate for Payer: Multiplan Commercial |
$1,241.65
|
| Rate for Payer: Networks By Design Commercial |
$827.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,407.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$621.32
|
| Rate for Payer: United Healthcare All Other HMO |
$604.77
|
| Rate for Payer: United Healthcare HMO Rider |
$591.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.19
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
IP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$824.89 |
| Rate for Payer: Adventist Health Commercial |
$183.31
|
| Rate for Payer: Blue Shield of California Commercial |
$708.49
|
| Rate for Payer: Blue Shield of California EPN |
$461.94
|
| Rate for Payer: Cash Price |
$504.10
|
| Rate for Payer: Central Health Plan Commercial |
$733.24
|
| Rate for Payer: Cigna of CA HMO |
$641.59
|
| Rate for Payer: Cigna of CA PPO |
$641.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Senior |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$824.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$567.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.31
|
| Rate for Payer: Multiplan Commercial |
$687.41
|
| Rate for Payer: Networks By Design Commercial |
$458.27
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.98
|
| Rate for Payer: United Healthcare All Other HMO |
$334.82
|
| Rate for Payer: United Healthcare HMO Rider |
$327.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.17
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
OP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$824.89 |
| Rate for Payer: Adventist Health Commercial |
$183.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$504.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$418.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$507.49
|
| Rate for Payer: Blue Shield of California Commercial |
$708.49
|
| Rate for Payer: Blue Shield of California EPN |
$461.94
|
| Rate for Payer: Cash Price |
$504.10
|
| Rate for Payer: Central Health Plan Commercial |
$733.24
|
| Rate for Payer: Cigna of CA HMO |
$641.59
|
| Rate for Payer: Cigna of CA PPO |
$641.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$779.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$779.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$779.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Senior |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$824.89
|
| Rate for Payer: InnovAge PACE Commercial |
$458.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$567.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$641.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$641.59
|
| Rate for Payer: Multiplan Commercial |
$687.41
|
| Rate for Payer: Networks By Design Commercial |
$458.27
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: Riverside University Health System MISP |
$366.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$549.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$549.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.98
|
| Rate for Payer: United Healthcare All Other HMO |
$334.82
|
| Rate for Payer: United Healthcare HMO Rider |
$327.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$779.07
|
| Rate for Payer: Vantage Medical Group Senior |
$779.07
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
OP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$846.63 |
| Rate for Payer: Adventist Health Commercial |
$188.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$429.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$520.87
|
| Rate for Payer: Blue Shield of California Commercial |
$727.16
|
| Rate for Payer: Blue Shield of California EPN |
$474.11
|
| Rate for Payer: Cash Price |
$517.39
|
| Rate for Payer: Central Health Plan Commercial |
$752.56
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Senior |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$846.63
|
| Rate for Payer: InnovAge PACE Commercial |
$470.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.49
|
| Rate for Payer: Multiplan Commercial |
$705.52
|
| Rate for Payer: Networks By Design Commercial |
$470.35
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$376.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.04
|
| Rate for Payer: United Healthcare All Other HMO |
$343.64
|
| Rate for Payer: United Healthcare HMO Rider |
$336.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.60
|
| Rate for Payer: Vantage Medical Group Senior |
$799.60
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
IP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$846.63 |
| Rate for Payer: Adventist Health Commercial |
$188.14
|
| Rate for Payer: Blue Shield of California Commercial |
$727.16
|
| Rate for Payer: Blue Shield of California EPN |
$474.11
|
| Rate for Payer: Cash Price |
$517.39
|
| Rate for Payer: Central Health Plan Commercial |
$752.56
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Senior |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$846.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.14
|
| Rate for Payer: Multiplan Commercial |
$705.52
|
| Rate for Payer: Networks By Design Commercial |
$470.35
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.04
|
| Rate for Payer: United Healthcare All Other HMO |
$343.64
|
| Rate for Payer: United Healthcare HMO Rider |
$336.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.08
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
IP
|
$1,521.08
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$304.22 |
| Max. Negotiated Rate |
$1,368.97 |
| Rate for Payer: Adventist Health Commercial |
$304.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,175.79
|
| Rate for Payer: Blue Shield of California EPN |
$766.62
|
| Rate for Payer: Cash Price |
$836.59
|
| Rate for Payer: Central Health Plan Commercial |
$1,216.86
|
| Rate for Payer: Cigna of CA HMO |
$1,064.76
|
| Rate for Payer: Cigna of CA PPO |
$1,064.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$608.43
|
| Rate for Payer: EPIC Health Plan Senior |
$608.43
|
| Rate for Payer: Galaxy Health WC |
$1,292.92
|
| Rate for Payer: Global Benefits Group Commercial |
$912.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,368.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,014.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$579.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$941.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$304.22
|
| Rate for Payer: Multiplan Commercial |
$1,140.81
|
| Rate for Payer: Networks By Design Commercial |
$760.54
|
| Rate for Payer: Prime Health Services Commercial |
$1,292.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$570.86
|
| Rate for Payer: United Healthcare All Other HMO |
$555.65
|
| Rate for Payer: United Healthcare HMO Rider |
$543.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$498.15
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
OP
|
$1,521.08
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$304.22 |
| Max. Negotiated Rate |
$1,368.97 |
| Rate for Payer: Adventist Health Commercial |
$304.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,292.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$836.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,140.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$694.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$842.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,175.79
|
| Rate for Payer: Blue Shield of California EPN |
$766.62
|
| Rate for Payer: Cash Price |
$836.59
|
| Rate for Payer: Central Health Plan Commercial |
$1,216.86
|
| Rate for Payer: Cigna of CA HMO |
$1,064.76
|
| Rate for Payer: Cigna of CA PPO |
$1,064.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,292.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,292.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,292.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$608.43
|
| Rate for Payer: EPIC Health Plan Senior |
$608.43
|
| Rate for Payer: Galaxy Health WC |
$1,292.92
|
| Rate for Payer: Global Benefits Group Commercial |
$912.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,368.97
|
| Rate for Payer: InnovAge PACE Commercial |
$760.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,014.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$579.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$941.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$304.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,064.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,064.76
|
| Rate for Payer: Multiplan Commercial |
$1,140.81
|
| Rate for Payer: Networks By Design Commercial |
$760.54
|
| Rate for Payer: Prime Health Services Commercial |
$1,292.92
|
| Rate for Payer: Riverside University Health System MISP |
$608.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$912.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$912.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$570.86
|
| Rate for Payer: United Healthcare All Other HMO |
$555.65
|
| Rate for Payer: United Healthcare HMO Rider |
$543.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$498.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,292.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,292.92
|
| Rate for Payer: Vantage Medical Group Senior |
$1,292.92
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
OP
|
$1,438.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.66 |
| Max. Negotiated Rate |
$1,294.45 |
| Rate for Payer: Adventist Health Commercial |
$287.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$791.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,078.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$656.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$796.38
|
| Rate for Payer: Blue Shield of California Commercial |
$1,111.79
|
| Rate for Payer: Blue Shield of California EPN |
$724.89
|
| Rate for Payer: Cash Price |
$791.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.62
|
| Rate for Payer: Cigna of CA HMO |
$1,006.80
|
| Rate for Payer: Cigna of CA PPO |
$1,006.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,222.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,222.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.31
|
| Rate for Payer: EPIC Health Plan Senior |
$575.31
|
| Rate for Payer: Galaxy Health WC |
$1,222.54
|
| Rate for Payer: Global Benefits Group Commercial |
$862.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.45
|
| Rate for Payer: InnovAge PACE Commercial |
$719.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$959.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$547.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$890.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,006.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,006.80
|
| Rate for Payer: Multiplan Commercial |
$1,078.71
|
| Rate for Payer: Networks By Design Commercial |
$719.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.54
|
| Rate for Payer: Riverside University Health System MISP |
$575.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$862.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$862.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$539.79
|
| Rate for Payer: United Healthcare All Other HMO |
$525.40
|
| Rate for Payer: United Healthcare HMO Rider |
$514.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,222.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,222.54
|
| Rate for Payer: Vantage Medical Group Senior |
$1,222.54
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
IP
|
$1,438.28
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.66 |
| Max. Negotiated Rate |
$1,294.45 |
| Rate for Payer: Adventist Health Commercial |
$287.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,111.79
|
| Rate for Payer: Blue Shield of California EPN |
$724.89
|
| Rate for Payer: Cash Price |
$791.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,150.62
|
| Rate for Payer: Cigna of CA HMO |
$1,006.80
|
| Rate for Payer: Cigna of CA PPO |
$1,006.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$575.31
|
| Rate for Payer: EPIC Health Plan Senior |
$575.31
|
| Rate for Payer: Galaxy Health WC |
$1,222.54
|
| Rate for Payer: Global Benefits Group Commercial |
$862.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,294.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$959.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$547.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$890.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$287.66
|
| Rate for Payer: Multiplan Commercial |
$1,078.71
|
| Rate for Payer: Networks By Design Commercial |
$719.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,222.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$539.79
|
| Rate for Payer: United Healthcare All Other HMO |
$525.40
|
| Rate for Payer: United Healthcare HMO Rider |
$514.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.04
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
IP
|
$1,514.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.83 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Adventist Health Commercial |
$302.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1,170.43
|
| Rate for Payer: Blue Shield of California EPN |
$763.13
|
| Rate for Payer: Cash Price |
$832.78
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.31
|
| Rate for Payer: Cigna of CA HMO |
$1,059.90
|
| Rate for Payer: Cigna of CA PPO |
$1,059.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.66
|
| Rate for Payer: EPIC Health Plan Senior |
$605.66
|
| Rate for Payer: Galaxy Health WC |
$1,287.02
|
| Rate for Payer: Global Benefits Group Commercial |
$908.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,362.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,009.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$937.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.83
|
| Rate for Payer: Multiplan Commercial |
$1,135.61
|
| Rate for Payer: Networks By Design Commercial |
$757.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.26
|
| Rate for Payer: United Healthcare All Other HMO |
$553.12
|
| Rate for Payer: United Healthcare HMO Rider |
$541.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.88
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
OP
|
$1,514.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.83 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Adventist Health Commercial |
$302.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$832.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,135.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$691.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$838.38
|
| Rate for Payer: Blue Shield of California Commercial |
$1,170.43
|
| Rate for Payer: Blue Shield of California EPN |
$763.13
|
| Rate for Payer: Cash Price |
$832.78
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.31
|
| Rate for Payer: Cigna of CA HMO |
$1,059.90
|
| Rate for Payer: Cigna of CA PPO |
$1,059.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,287.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,287.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.66
|
| Rate for Payer: EPIC Health Plan Senior |
$605.66
|
| Rate for Payer: Galaxy Health WC |
$1,287.02
|
| Rate for Payer: Global Benefits Group Commercial |
$908.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,362.73
|
| Rate for Payer: InnovAge PACE Commercial |
$757.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,009.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$937.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,059.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,059.90
|
| Rate for Payer: Multiplan Commercial |
$1,135.61
|
| Rate for Payer: Networks By Design Commercial |
$757.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.02
|
| Rate for Payer: Riverside University Health System MISP |
$605.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$908.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$908.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.26
|
| Rate for Payer: United Healthcare All Other HMO |
$553.12
|
| Rate for Payer: United Healthcare HMO Rider |
$541.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,287.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,287.02
|
| Rate for Payer: Vantage Medical Group Senior |
$1,287.02
|
|
|
HC CATH PICC PWR 4.5FR SL 40CM
|
Facility
|
IP
|
$1,395.32
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$279.06 |
| Max. Negotiated Rate |
$1,255.79 |
| Rate for Payer: Adventist Health Commercial |
$279.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,078.58
|
| Rate for Payer: Blue Shield of California EPN |
$703.24
|
| Rate for Payer: Cash Price |
$767.43
|
| Rate for Payer: Central Health Plan Commercial |
$1,116.26
|
| Rate for Payer: Cigna of CA HMO |
$976.72
|
| Rate for Payer: Cigna of CA PPO |
$976.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$558.13
|
| Rate for Payer: EPIC Health Plan Senior |
$558.13
|
| Rate for Payer: Galaxy Health WC |
$1,186.02
|
| Rate for Payer: Global Benefits Group Commercial |
$837.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,255.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$930.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$863.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.06
|
| Rate for Payer: Multiplan Commercial |
$1,046.49
|
| Rate for Payer: Networks By Design Commercial |
$697.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,186.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$523.66
|
| Rate for Payer: United Healthcare All Other HMO |
$509.71
|
| Rate for Payer: United Healthcare HMO Rider |
$498.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$456.97
|
|
|
HC CATH PICC PWR 4.5FR SL 40CM
|
Facility
|
OP
|
$1,395.32
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$279.06 |
| Max. Negotiated Rate |
$1,255.79 |
| Rate for Payer: Adventist Health Commercial |
$279.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$767.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,046.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$637.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$772.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1,078.58
|
| Rate for Payer: Blue Shield of California EPN |
$703.24
|
| Rate for Payer: Cash Price |
$767.43
|
| Rate for Payer: Central Health Plan Commercial |
$1,116.26
|
| Rate for Payer: Cigna of CA HMO |
$976.72
|
| Rate for Payer: Cigna of CA PPO |
$976.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,186.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,186.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$558.13
|
| Rate for Payer: EPIC Health Plan Senior |
$558.13
|
| Rate for Payer: Galaxy Health WC |
$1,186.02
|
| Rate for Payer: Global Benefits Group Commercial |
$837.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,255.79
|
| Rate for Payer: InnovAge PACE Commercial |
$697.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$930.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$531.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$863.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$976.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$976.72
|
| Rate for Payer: Multiplan Commercial |
$1,046.49
|
| Rate for Payer: Networks By Design Commercial |
$697.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,186.02
|
| Rate for Payer: Riverside University Health System MISP |
$558.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$837.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$837.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$523.66
|
| Rate for Payer: United Healthcare All Other HMO |
$509.71
|
| Rate for Payer: United Healthcare HMO Rider |
$498.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$456.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,186.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,186.02
|
| Rate for Payer: Vantage Medical Group Senior |
$1,186.02
|
|
|
HC CATH PICC PWR 4FR SL
|
Facility
|
IP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Adventist Health Commercial |
$255.53
|
| Rate for Payer: Blue Shield of California Commercial |
$987.62
|
| Rate for Payer: Blue Shield of California EPN |
$643.94
|
| Rate for Payer: Cash Price |
$702.71
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Senior |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$852.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$790.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Networks By Design Commercial |
$638.83
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.50
|
| Rate for Payer: United Healthcare All Other HMO |
$466.73
|
| Rate for Payer: United Healthcare HMO Rider |
$456.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.43
|
|
|
HC CATH PICC PWR 4FR SL
|
Facility
|
OP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Adventist Health Commercial |
$255.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$702.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$958.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$583.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$707.43
|
| Rate for Payer: Blue Shield of California Commercial |
$987.62
|
| Rate for Payer: Blue Shield of California EPN |
$643.94
|
| Rate for Payer: Cash Price |
$702.71
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,086.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,086.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Senior |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: InnovAge PACE Commercial |
$638.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$852.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$790.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$894.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$894.36
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Networks By Design Commercial |
$638.83
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: Riverside University Health System MISP |
$511.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$766.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$766.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.50
|
| Rate for Payer: United Healthcare All Other HMO |
$466.73
|
| Rate for Payer: United Healthcare HMO Rider |
$456.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,086.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,086.00
|
|
|
HC CATH PICC PWR 4FR SL 40CM VPS
|
Facility
|
OP
|
$1,225.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607737
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$245.02 |
| Max. Negotiated Rate |
$1,102.61 |
| Rate for Payer: Adventist Health Commercial |
$245.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$673.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$918.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$559.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$678.35
|
| Rate for Payer: Blue Shield of California Commercial |
$947.02
|
| Rate for Payer: Blue Shield of California EPN |
$617.46
|
| Rate for Payer: Cash Price |
$673.82
|
| Rate for Payer: Central Health Plan Commercial |
$980.10
|
| Rate for Payer: Cigna of CA HMO |
$857.58
|
| Rate for Payer: Cigna of CA PPO |
$857.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,041.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,041.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$490.05
|
| Rate for Payer: EPIC Health Plan Senior |
$490.05
|
| Rate for Payer: Galaxy Health WC |
$1,041.35
|
| Rate for Payer: Global Benefits Group Commercial |
$735.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,102.61
|
| Rate for Payer: InnovAge PACE Commercial |
$612.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$817.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$466.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$758.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$245.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$857.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$857.58
|
| Rate for Payer: Multiplan Commercial |
$918.84
|
| Rate for Payer: Networks By Design Commercial |
$612.56
|
| Rate for Payer: Prime Health Services Commercial |
$1,041.35
|
| Rate for Payer: Riverside University Health System MISP |
$490.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$735.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$735.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$459.79
|
| Rate for Payer: United Healthcare All Other HMO |
$447.54
|
| Rate for Payer: United Healthcare HMO Rider |
$437.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$401.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,041.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,041.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,041.35
|
|
