|
HC CATH PICC PWR 4FR SL 40CM VPS
|
Facility
|
IP
|
$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: 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: 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: 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: 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: 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
|
|
|
HC CATH PICC PWR 5.5FR 45CM DL
|
Facility
|
OP
|
$1,717.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.44 |
| Max. Negotiated Rate |
$1,545.46 |
| Rate for Payer: Adventist Health Commercial |
$343.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$944.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,287.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$784.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$950.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,327.38
|
| Rate for Payer: Blue Shield of California EPN |
$865.46
|
| Rate for Payer: Cash Price |
$944.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.74
|
| Rate for Payer: Cigna of CA HMO |
$1,202.03
|
| Rate for Payer: Cigna of CA PPO |
$1,202.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,459.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,459.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.87
|
| Rate for Payer: EPIC Health Plan Senior |
$686.87
|
| Rate for Payer: Galaxy Health WC |
$1,459.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.46
|
| Rate for Payer: InnovAge PACE Commercial |
$858.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,145.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$654.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,062.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,202.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,202.03
|
| Rate for Payer: Multiplan Commercial |
$1,287.88
|
| Rate for Payer: Networks By Design Commercial |
$858.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.60
|
| Rate for Payer: Riverside University Health System MISP |
$686.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,030.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,030.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.46
|
| Rate for Payer: United Healthcare All Other HMO |
$627.29
|
| Rate for Payer: United Healthcare HMO Rider |
$613.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$562.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,459.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,459.60
|
|
|
HC CATH PICC PWR 5.5FR 45CM DL
|
Facility
|
IP
|
$1,717.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.44 |
| Max. Negotiated Rate |
$1,545.46 |
| Rate for Payer: Adventist Health Commercial |
$343.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,327.38
|
| Rate for Payer: Blue Shield of California EPN |
$865.46
|
| Rate for Payer: Cash Price |
$944.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.74
|
| Rate for Payer: Cigna of CA HMO |
$1,202.03
|
| Rate for Payer: Cigna of CA PPO |
$1,202.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.87
|
| Rate for Payer: EPIC Health Plan Senior |
$686.87
|
| Rate for Payer: Galaxy Health WC |
$1,459.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,145.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$654.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,062.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.44
|
| Rate for Payer: Multiplan Commercial |
$1,287.88
|
| Rate for Payer: Networks By Design Commercial |
$858.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.46
|
| Rate for Payer: United Healthcare All Other HMO |
$627.29
|
| Rate for Payer: United Healthcare HMO Rider |
$613.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$562.38
|
|
|
HC CATH PICC PWR 5.5FR 50CM DL
|
Facility
|
IP
|
$1,459.17
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.83 |
| Max. Negotiated Rate |
$1,313.25 |
| Rate for Payer: Adventist Health Commercial |
$291.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1,127.94
|
| Rate for Payer: Blue Shield of California EPN |
$735.42
|
| Rate for Payer: Cash Price |
$802.54
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.34
|
| Rate for Payer: Cigna of CA HMO |
$1,021.42
|
| Rate for Payer: Cigna of CA PPO |
$1,021.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$583.67
|
| Rate for Payer: EPIC Health Plan Senior |
$583.67
|
| Rate for Payer: Galaxy Health WC |
$1,240.29
|
| Rate for Payer: Global Benefits Group Commercial |
$875.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$973.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$555.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.83
|
| Rate for Payer: Multiplan Commercial |
$1,094.38
|
| Rate for Payer: Networks By Design Commercial |
$729.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.63
|
| Rate for Payer: United Healthcare All Other HMO |
$533.03
|
| Rate for Payer: United Healthcare HMO Rider |
$521.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$477.88
|
|
|
HC CATH PICC PWR 5.5FR 50CM DL
|
Facility
|
OP
|
$1,459.17
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.83 |
| Max. Negotiated Rate |
$1,313.25 |
| Rate for Payer: Adventist Health Commercial |
$291.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$802.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,094.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$666.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$807.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,127.94
|
| Rate for Payer: Blue Shield of California EPN |
$735.42
|
| Rate for Payer: Cash Price |
$802.54
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.34
|
| Rate for Payer: Cigna of CA HMO |
$1,021.42
|
| Rate for Payer: Cigna of CA PPO |
$1,021.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,240.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,240.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$583.67
|
| Rate for Payer: EPIC Health Plan Senior |
$583.67
|
| Rate for Payer: Galaxy Health WC |
$1,240.29
|
| Rate for Payer: Global Benefits Group Commercial |
$875.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.25
|
| Rate for Payer: InnovAge PACE Commercial |
$729.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$973.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$555.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$903.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,021.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,021.42
|
| Rate for Payer: Multiplan Commercial |
$1,094.38
|
| Rate for Payer: Networks By Design Commercial |
$729.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.29
|
| Rate for Payer: Riverside University Health System MISP |
$583.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$875.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$547.63
|
| Rate for Payer: United Healthcare All Other HMO |
$533.03
|
| Rate for Payer: United Healthcare HMO Rider |
$521.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$477.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,240.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,240.29
|
| Rate for Payer: Vantage Medical Group Senior |
$1,240.29
|
|
|
HC CATH PICC PWR 5.5FR 55CM DL
|
Facility
|
IP
|
$1,572.88
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,415.59 |
| Rate for Payer: Adventist Health Commercial |
$314.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,215.84
|
| Rate for Payer: Blue Shield of California EPN |
$792.73
|
| Rate for Payer: Cash Price |
$865.08
|
| Rate for Payer: Central Health Plan Commercial |
$1,258.30
|
| Rate for Payer: Cigna of CA HMO |
$1,101.02
|
| Rate for Payer: Cigna of CA PPO |
$1,101.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$629.15
|
| Rate for Payer: EPIC Health Plan Senior |
$629.15
|
| Rate for Payer: Galaxy Health WC |
$1,336.95
|
| Rate for Payer: Global Benefits Group Commercial |
$943.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,415.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,049.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$599.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$973.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.58
|
| Rate for Payer: Multiplan Commercial |
$1,179.66
|
| Rate for Payer: Networks By Design Commercial |
$786.44
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.30
|
| Rate for Payer: United Healthcare All Other HMO |
$574.57
|
| Rate for Payer: United Healthcare HMO Rider |
$562.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.12
|
|
|
HC CATH PICC PWR 5.5FR 55CM DL
|
Facility
|
OP
|
$1,572.88
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,415.59 |
| Rate for Payer: Adventist Health Commercial |
$314.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$865.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,179.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$718.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$870.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,215.84
|
| Rate for Payer: Blue Shield of California EPN |
$792.73
|
| Rate for Payer: Cash Price |
$865.08
|
| Rate for Payer: Central Health Plan Commercial |
$1,258.30
|
| Rate for Payer: Cigna of CA HMO |
$1,101.02
|
| Rate for Payer: Cigna of CA PPO |
$1,101.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,336.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,336.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$629.15
|
| Rate for Payer: EPIC Health Plan Senior |
$629.15
|
| Rate for Payer: Galaxy Health WC |
$1,336.95
|
| Rate for Payer: Global Benefits Group Commercial |
$943.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,415.59
|
| Rate for Payer: InnovAge PACE Commercial |
$786.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,049.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$599.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$973.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,101.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,101.02
|
| Rate for Payer: Multiplan Commercial |
$1,179.66
|
| Rate for Payer: Networks By Design Commercial |
$786.44
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.95
|
| Rate for Payer: Riverside University Health System MISP |
$629.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$943.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$943.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.30
|
| Rate for Payer: United Healthcare All Other HMO |
$574.57
|
| Rate for Payer: United Healthcare HMO Rider |
$562.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,336.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,336.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,336.95
|
|
|
HC CATH PICC PWR 5.5FR DL 40CM
|
Facility
|
IP
|
$1,400.29
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.06 |
| Max. Negotiated Rate |
$1,260.26 |
| Rate for Payer: Adventist Health Commercial |
$280.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.42
|
| Rate for Payer: Blue Shield of California EPN |
$705.75
|
| Rate for Payer: Cash Price |
$770.16
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.23
|
| Rate for Payer: Cigna of CA HMO |
$980.20
|
| Rate for Payer: Cigna of CA PPO |
$980.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.12
|
| Rate for Payer: EPIC Health Plan Senior |
$560.12
|
| Rate for Payer: Galaxy Health WC |
$1,190.25
|
| Rate for Payer: Global Benefits Group Commercial |
$840.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$866.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$1,050.22
|
| Rate for Payer: Networks By Design Commercial |
$700.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.53
|
| Rate for Payer: United Healthcare All Other HMO |
$511.53
|
| Rate for Payer: United Healthcare HMO Rider |
$500.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.59
|
|
|
HC CATH PICC PWR 5.5FR DL 40CM
|
Facility
|
OP
|
$1,400.29
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.06 |
| Max. Negotiated Rate |
$1,260.26 |
| Rate for Payer: Adventist Health Commercial |
$280.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$770.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,050.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$639.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$775.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.42
|
| Rate for Payer: Blue Shield of California EPN |
$705.75
|
| Rate for Payer: Cash Price |
$770.16
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.23
|
| Rate for Payer: Cigna of CA HMO |
$980.20
|
| Rate for Payer: Cigna of CA PPO |
$980.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,190.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,190.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.12
|
| Rate for Payer: EPIC Health Plan Senior |
$560.12
|
| Rate for Payer: Galaxy Health WC |
$1,190.25
|
| Rate for Payer: Global Benefits Group Commercial |
$840.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.26
|
| Rate for Payer: InnovAge PACE Commercial |
$700.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$866.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$980.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$980.20
|
| Rate for Payer: Multiplan Commercial |
$1,050.22
|
| Rate for Payer: Networks By Design Commercial |
$700.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.25
|
| Rate for Payer: Riverside University Health System MISP |
$560.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$840.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$840.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.53
|
| Rate for Payer: United Healthcare All Other HMO |
$511.53
|
| Rate for Payer: United Healthcare HMO Rider |
$500.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,190.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,190.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,190.25
|
|
|
HC CATH PICC PWR 5FR DL 40CM VPS
|
Facility
|
IP
|
$1,298.72
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.74 |
| Max. Negotiated Rate |
$1,168.85 |
| Rate for Payer: Adventist Health Commercial |
$259.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,003.91
|
| Rate for Payer: Blue Shield of California EPN |
$654.55
|
| Rate for Payer: Cash Price |
$714.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,038.98
|
| Rate for Payer: Cigna of CA HMO |
$909.10
|
| Rate for Payer: Cigna of CA PPO |
$909.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$519.49
|
| Rate for Payer: EPIC Health Plan Senior |
$519.49
|
| Rate for Payer: Galaxy Health WC |
$1,103.91
|
| Rate for Payer: Global Benefits Group Commercial |
$779.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,168.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$866.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$494.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.74
|
| Rate for Payer: Multiplan Commercial |
$974.04
|
| Rate for Payer: Networks By Design Commercial |
$649.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,103.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$487.41
|
| Rate for Payer: United Healthcare All Other HMO |
$474.42
|
| Rate for Payer: United Healthcare HMO Rider |
$464.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.33
|
|
|
HC CATH PICC PWR 5FR DL 40CM VPS
|
Facility
|
OP
|
$1,298.72
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.74 |
| Max. Negotiated Rate |
$1,168.85 |
| Rate for Payer: Adventist Health Commercial |
$259.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$714.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$974.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$593.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$719.10
|
| Rate for Payer: Blue Shield of California Commercial |
$1,003.91
|
| Rate for Payer: Blue Shield of California EPN |
$654.55
|
| Rate for Payer: Cash Price |
$714.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,038.98
|
| Rate for Payer: Cigna of CA HMO |
$909.10
|
| Rate for Payer: Cigna of CA PPO |
$909.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,103.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,103.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$519.49
|
| Rate for Payer: EPIC Health Plan Senior |
$519.49
|
| Rate for Payer: Galaxy Health WC |
$1,103.91
|
| Rate for Payer: Global Benefits Group Commercial |
$779.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,168.85
|
| Rate for Payer: InnovAge PACE Commercial |
$649.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$866.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$494.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$803.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$909.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$909.10
|
| Rate for Payer: Multiplan Commercial |
$974.04
|
| Rate for Payer: Networks By Design Commercial |
$649.36
|
| Rate for Payer: Prime Health Services Commercial |
$1,103.91
|
| Rate for Payer: Riverside University Health System MISP |
$519.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$779.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$779.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$487.41
|
| Rate for Payer: United Healthcare All Other HMO |
$474.42
|
| Rate for Payer: United Healthcare HMO Rider |
$464.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,103.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,103.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,103.91
|
|
|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
IP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$1,299.96 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,116.52
|
| Rate for Payer: Blue Shield of California EPN |
$727.98
|
| Rate for Payer: Cash Price |
$794.42
|
| Rate for Payer: Central Health Plan Commercial |
$1,155.52
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,299.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$963.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$894.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.88
|
| Rate for Payer: Multiplan Commercial |
$1,083.30
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
|
|
HC CATH PICC PWR 6FR 50CM TL
|
Facility
|
OP
|
$1,444.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.88 |
| Max. Negotiated Rate |
$1,299.96 |
| Rate for Payer: Adventist Health Commercial |
$288.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$794.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,083.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$659.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$799.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1,116.52
|
| Rate for Payer: Blue Shield of California EPN |
$727.98
|
| Rate for Payer: Cash Price |
$794.42
|
| Rate for Payer: Central Health Plan Commercial |
$1,155.52
|
| Rate for Payer: Cigna of CA HMO |
$1,011.08
|
| Rate for Payer: Cigna of CA PPO |
$1,011.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,227.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,227.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$577.76
|
| Rate for Payer: EPIC Health Plan Senior |
$577.76
|
| Rate for Payer: Galaxy Health WC |
$1,227.74
|
| Rate for Payer: Global Benefits Group Commercial |
$866.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,299.96
|
| Rate for Payer: InnovAge PACE Commercial |
$722.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$963.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$894.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,011.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,011.08
|
| Rate for Payer: Multiplan Commercial |
$1,083.30
|
| Rate for Payer: Networks By Design Commercial |
$722.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,227.74
|
| Rate for Payer: Riverside University Health System MISP |
$577.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$866.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$866.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.08
|
| Rate for Payer: United Healthcare All Other HMO |
$527.64
|
| Rate for Payer: United Healthcare HMO Rider |
$516.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$473.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,227.74
|
| Rate for Payer: Vantage Medical Group Senior |
$1,227.74
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
IP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$1,334.03 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,145.79
|
| Rate for Payer: Blue Shield of California EPN |
$747.06
|
| Rate for Payer: Cash Price |
$815.24
|
| Rate for Payer: Central Health Plan Commercial |
$1,185.81
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,334.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$988.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$564.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$917.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.45
|
| Rate for Payer: Multiplan Commercial |
$1,111.69
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
|
|
HC CATH PICC PWR 6FR TL 40CM CG
|
Facility
|
OP
|
$1,482.26
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607742
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.45 |
| Max. Negotiated Rate |
$1,334.03 |
| Rate for Payer: Adventist Health Commercial |
$296.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$815.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,111.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$676.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$820.73
|
| Rate for Payer: Blue Shield of California Commercial |
$1,145.79
|
| Rate for Payer: Blue Shield of California EPN |
$747.06
|
| Rate for Payer: Cash Price |
$815.24
|
| Rate for Payer: Central Health Plan Commercial |
$1,185.81
|
| Rate for Payer: Cigna of CA HMO |
$1,037.58
|
| Rate for Payer: Cigna of CA PPO |
$1,037.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,259.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,259.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.90
|
| Rate for Payer: EPIC Health Plan Senior |
$592.90
|
| Rate for Payer: Galaxy Health WC |
$1,259.92
|
| Rate for Payer: Global Benefits Group Commercial |
$889.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,334.03
|
| Rate for Payer: InnovAge PACE Commercial |
$741.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$988.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$564.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$917.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,037.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,037.58
|
| Rate for Payer: Multiplan Commercial |
$1,111.69
|
| Rate for Payer: Networks By Design Commercial |
$741.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,259.92
|
| Rate for Payer: Riverside University Health System MISP |
$592.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$889.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$889.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.29
|
| Rate for Payer: United Healthcare All Other HMO |
$541.47
|
| Rate for Payer: United Healthcare HMO Rider |
$529.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,259.92
|
| Rate for Payer: Vantage Medical Group Senior |
$1,259.92
|
|
|
HC CATH PICC PWR 6FR TL 40CM VPS
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607741
|
|
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 PWR 6FR TL 40CM VPS
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607741
|
|
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
|
|
|
HC CATH PICC PWR 6FR TL 55CM VPS
|
Facility
|
IP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$1,363.43 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1,171.03
|
| Rate for Payer: Blue Shield of California EPN |
$763.52
|
| Rate for Payer: Cash Price |
$833.21
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.94
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,363.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,010.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$577.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$937.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.98
|
| Rate for Payer: Multiplan Commercial |
$1,136.19
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
|
|
HC CATH PICC PWR 6FR TL 55CM VPS
|
Facility
|
OP
|
$1,514.92
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607858
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.98 |
| Max. Negotiated Rate |
$1,363.43 |
| Rate for Payer: Adventist Health Commercial |
$302.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$833.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,136.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$691.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$838.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,171.03
|
| Rate for Payer: Blue Shield of California EPN |
$763.52
|
| Rate for Payer: Cash Price |
$833.21
|
| Rate for Payer: Central Health Plan Commercial |
$1,211.94
|
| Rate for Payer: Cigna of CA HMO |
$1,060.44
|
| Rate for Payer: Cigna of CA PPO |
$1,060.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,287.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,287.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.97
|
| Rate for Payer: EPIC Health Plan Senior |
$605.97
|
| Rate for Payer: Galaxy Health WC |
$1,287.68
|
| Rate for Payer: Global Benefits Group Commercial |
$908.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,363.43
|
| Rate for Payer: InnovAge PACE Commercial |
$757.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,010.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$577.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$937.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,060.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,060.44
|
| Rate for Payer: Multiplan Commercial |
$1,136.19
|
| Rate for Payer: Networks By Design Commercial |
$757.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,287.68
|
| Rate for Payer: Riverside University Health System MISP |
$605.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$908.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$908.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.55
|
| Rate for Payer: United Healthcare All Other HMO |
$553.40
|
| Rate for Payer: United Healthcare HMO Rider |
$541.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$496.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,287.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,287.68
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
OP
|
$353.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$318.27 |
| Rate for Payer: Adventist Health Commercial |
$70.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$265.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$161.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.80
|
| Rate for Payer: Blue Shield of California Commercial |
$273.36
|
| Rate for Payer: Blue Shield of California EPN |
$178.23
|
| Rate for Payer: Cash Price |
$194.50
|
| Rate for Payer: Central Health Plan Commercial |
$282.90
|
| Rate for Payer: Cigna of CA HMO |
$247.54
|
| Rate for Payer: Cigna of CA PPO |
$247.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$300.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$300.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.45
|
| Rate for Payer: EPIC Health Plan Senior |
$141.45
|
| Rate for Payer: Galaxy Health WC |
$300.59
|
| Rate for Payer: Global Benefits Group Commercial |
$212.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$318.27
|
| Rate for Payer: InnovAge PACE Commercial |
$176.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$235.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$218.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$247.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$247.54
|
| Rate for Payer: Multiplan Commercial |
$265.22
|
| Rate for Payer: Networks By Design Commercial |
$176.81
|
| Rate for Payer: Prime Health Services Commercial |
$300.59
|
| Rate for Payer: Riverside University Health System MISP |
$141.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$212.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$212.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$129.18
|
| Rate for Payer: United Healthcare HMO Rider |
$126.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$300.59
|
| Rate for Payer: Vantage Medical Group Senior |
$300.59
|
|
|
HC CATH PICC SILICONE 1.9FR
|
Facility
|
IP
|
$353.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$318.27 |
| Rate for Payer: Adventist Health Commercial |
$70.73
|
| Rate for Payer: Blue Shield of California Commercial |
$273.36
|
| Rate for Payer: Blue Shield of California EPN |
$178.23
|
| Rate for Payer: Cash Price |
$194.50
|
| Rate for Payer: Central Health Plan Commercial |
$282.90
|
| Rate for Payer: Cigna of CA HMO |
$247.54
|
| Rate for Payer: Cigna of CA PPO |
$247.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.45
|
| Rate for Payer: EPIC Health Plan Senior |
$141.45
|
| Rate for Payer: Galaxy Health WC |
$300.59
|
| Rate for Payer: Global Benefits Group Commercial |
$212.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$318.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$235.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$218.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.73
|
| Rate for Payer: Multiplan Commercial |
$265.22
|
| Rate for Payer: Networks By Design Commercial |
$176.81
|
| Rate for Payer: Prime Health Services Commercial |
$300.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$129.18
|
| Rate for Payer: United Healthcare HMO Rider |
$126.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.81
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$614.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$759.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$594.35
|
| Rate for Payer: Blue Shield of California Commercial |
$618.33
|
| Rate for Payer: Blue Shield of California EPN |
$403.79
|
| Rate for Payer: Cash Price |
$556.60
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$860.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: InnovAge PACE Commercial |
$506.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$708.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$708.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC CATH PICC TLS 5FR POWER MAX
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Adventist Health Commercial |
$202.40
|
| Rate for Payer: Cash Price |
$556.60
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Senior |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$626.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
OP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$591.03 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$398.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$361.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$492.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$317.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$385.68
|
| Rate for Payer: Blue Shield of California Commercial |
$401.24
|
| Rate for Payer: Blue Shield of California EPN |
$262.02
|
| Rate for Payer: Cash Price |
$361.19
|
| Rate for Payer: Central Health Plan Commercial |
$525.36
|
| Rate for Payer: Cigna of CA HMO |
$420.29
|
| Rate for Payer: Cigna of CA PPO |
$485.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$558.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$558.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.03
|
| Rate for Payer: InnovAge PACE Commercial |
$328.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$406.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$459.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$459.69
|
| Rate for Payer: Multiplan Commercial |
$492.52
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
| Rate for Payer: Riverside University Health System MISP |
$262.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.35
|
| Rate for Payer: United Healthcare All Other HMO |
$328.35
|
| Rate for Payer: United Healthcare HMO Rider |
$328.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$558.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.20
|
| Rate for Payer: Vantage Medical Group Senior |
$558.20
|
|
|
HC CATH PICC TLS DL 2.6FR X 20CM
|
Facility
|
IP
|
$656.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.34 |
| Max. Negotiated Rate |
$591.03 |
| Rate for Payer: Adventist Health Commercial |
$131.34
|
| Rate for Payer: Cash Price |
$361.19
|
| Rate for Payer: Central Health Plan Commercial |
$525.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.68
|
| Rate for Payer: EPIC Health Plan Senior |
$262.68
|
| Rate for Payer: Galaxy Health WC |
$558.20
|
| Rate for Payer: Global Benefits Group Commercial |
$394.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$406.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.34
|
| Rate for Payer: Multiplan Commercial |
$492.52
|
| Rate for Payer: Networks By Design Commercial |
$426.86
|
| Rate for Payer: Prime Health Services Commercial |
$558.20
|
|
