|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PICC TLS DL 2.6FR X 50CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$62.12
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.33
|
| Rate for Payer: Blue Shield of California Commercial |
$69.01
|
| Rate for Payer: Blue Shield of California EPN |
$45.06
|
| Rate for Payer: Cash Price |
$62.12
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Cigna of CA HMO |
$72.28
|
| Rate for Payer: Cigna of CA PPO |
$83.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: InnovAge PACE Commercial |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Riverside University Health System MISP |
$45.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.47
|
| Rate for Payer: United Healthcare All Other HMO |
$56.47
|
| Rate for Payer: United Healthcare HMO Rider |
$56.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
IP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Cash Price |
$62.74
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
OP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Adventist Health Commercial |
$22.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.00
|
| Rate for Payer: Blue Shield of California Commercial |
$69.70
|
| Rate for Payer: Blue Shield of California EPN |
$45.52
|
| Rate for Payer: Cash Price |
$62.74
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: InnovAge PACE Commercial |
$57.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.86
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Riverside University Health System MISP |
$45.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC CATH PIV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$232.05
|
|
| Hospital Charge Code |
901698174
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$208.84 |
| Rate for Payer: Adventist Health Commercial |
$46.41
|
| Rate for Payer: Cash Price |
$127.63
|
| Rate for Payer: Central Health Plan Commercial |
$185.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.82
|
| Rate for Payer: EPIC Health Plan Senior |
$92.82
|
| Rate for Payer: Galaxy Health WC |
$197.24
|
| Rate for Payer: Global Benefits Group Commercial |
$139.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.41
|
| Rate for Payer: Multiplan Commercial |
$174.04
|
| Rate for Payer: Networks By Design Commercial |
$150.83
|
| Rate for Payer: Prime Health Services Commercial |
$197.24
|
|
|
HC CATH PIV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$232.05
|
|
| Hospital Charge Code |
901698174
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$208.84 |
| Rate for Payer: Adventist Health Commercial |
$46.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$197.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.28
|
| Rate for Payer: Blue Shield of California Commercial |
$141.78
|
| Rate for Payer: Blue Shield of California EPN |
$92.59
|
| Rate for Payer: Cash Price |
$127.63
|
| Rate for Payer: Central Health Plan Commercial |
$185.64
|
| Rate for Payer: Cigna of CA HMO |
$148.51
|
| Rate for Payer: Cigna of CA PPO |
$171.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$197.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$197.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$197.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.82
|
| Rate for Payer: EPIC Health Plan Senior |
$92.82
|
| Rate for Payer: Galaxy Health WC |
$197.24
|
| Rate for Payer: Global Benefits Group Commercial |
$139.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.84
|
| Rate for Payer: InnovAge PACE Commercial |
$116.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$162.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$174.04
|
| Rate for Payer: Networks By Design Commercial |
$150.83
|
| Rate for Payer: Prime Health Services Commercial |
$197.24
|
| Rate for Payer: Riverside University Health System MISP |
$92.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.03
|
| Rate for Payer: United Healthcare All Other HMO |
$116.03
|
| Rate for Payer: United Healthcare HMO Rider |
$116.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$197.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$197.24
|
| Rate for Payer: Vantage Medical Group Senior |
$197.24
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
OP
|
$608.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$547.26 |
| Rate for Payer: Adventist Health Commercial |
$121.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$516.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$334.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$456.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$277.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$336.69
|
| Rate for Payer: Blue Shield of California Commercial |
$470.04
|
| Rate for Payer: Blue Shield of California EPN |
$306.47
|
| Rate for Payer: Cash Price |
$334.44
|
| Rate for Payer: Central Health Plan Commercial |
$486.46
|
| Rate for Payer: Cigna of CA HMO |
$425.65
|
| Rate for Payer: Cigna of CA PPO |
$425.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$516.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$516.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$516.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.23
|
| Rate for Payer: EPIC Health Plan Senior |
$243.23
|
| Rate for Payer: Galaxy Health WC |
$516.86
|
| Rate for Payer: Global Benefits Group Commercial |
$364.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$547.26
|
| Rate for Payer: InnovAge PACE Commercial |
$304.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$405.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$376.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$425.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.65
|
| Rate for Payer: Multiplan Commercial |
$456.05
|
| Rate for Payer: Networks By Design Commercial |
$304.04
|
| Rate for Payer: Prime Health Services Commercial |
$516.86
|
| Rate for Payer: Riverside University Health System MISP |
$243.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$364.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$364.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.21
|
| Rate for Payer: United Healthcare All Other HMO |
$222.13
|
| Rate for Payer: United Healthcare HMO Rider |
$217.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$516.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$516.86
|
| Rate for Payer: Vantage Medical Group Senior |
$516.86
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
IP
|
$608.07
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$547.26 |
| Rate for Payer: Adventist Health Commercial |
$121.61
|
| Rate for Payer: Blue Shield of California Commercial |
$470.04
|
| Rate for Payer: Blue Shield of California EPN |
$306.47
|
| Rate for Payer: Cash Price |
$334.44
|
| Rate for Payer: Central Health Plan Commercial |
$486.46
|
| Rate for Payer: Cigna of CA HMO |
$425.65
|
| Rate for Payer: Cigna of CA PPO |
$425.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$243.23
|
| Rate for Payer: EPIC Health Plan Senior |
$243.23
|
| Rate for Payer: Galaxy Health WC |
$516.86
|
| Rate for Payer: Global Benefits Group Commercial |
$364.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$547.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$405.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$376.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.61
|
| Rate for Payer: Multiplan Commercial |
$456.05
|
| Rate for Payer: Networks By Design Commercial |
$304.04
|
| Rate for Payer: Prime Health Services Commercial |
$516.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.21
|
| Rate for Payer: United Healthcare All Other HMO |
$222.13
|
| Rate for Payer: United Healthcare HMO Rider |
$217.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.14
|
|
|
HC CATH PMO LICOX
|
Facility
|
OP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,398.53 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,293.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,076.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,832.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,828.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,217.73
|
| Rate for Payer: Blue Shield of California Commercial |
$2,307.22
|
| Rate for Payer: Blue Shield of California EPN |
$1,506.68
|
| Rate for Payer: Cash Price |
$2,076.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,020.91
|
| Rate for Payer: Cigna of CA HMO |
$2,416.73
|
| Rate for Payer: Cigna of CA PPO |
$2,794.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,209.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,209.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,398.53
|
| Rate for Payer: InnovAge PACE Commercial |
$1,888.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,518.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,438.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,337.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,643.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,643.30
|
| Rate for Payer: Multiplan Commercial |
$2,832.11
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
| Rate for Payer: Riverside University Health System MISP |
$1,510.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,265.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,265.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,888.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1,888.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1,888.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,888.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,209.72
|
| Rate for Payer: Vantage Medical Group Senior |
$3,209.72
|
|
|
HC CATH PMO LICOX
|
Facility
|
IP
|
$3,776.14
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$755.23 |
| Max. Negotiated Rate |
$3,398.53 |
| Rate for Payer: Adventist Health Commercial |
$755.23
|
| Rate for Payer: Cash Price |
$2,076.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,020.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,510.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,510.46
|
| Rate for Payer: Galaxy Health WC |
$3,209.72
|
| Rate for Payer: Global Benefits Group Commercial |
$2,265.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,398.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,518.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,438.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,337.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.23
|
| Rate for Payer: Multiplan Commercial |
$2,832.11
|
| Rate for Payer: Networks By Design Commercial |
$2,454.49
|
| Rate for Payer: Prime Health Services Commercial |
$3,209.72
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$178.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.78
|
| Rate for Payer: Blue Shield of California Commercial |
$145.42
|
| Rate for Payer: Blue Shield of California EPN |
$94.96
|
| Rate for Payer: Cash Price |
$130.90
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$202.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: InnovAge PACE Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$166.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Riverside University Health System MISP |
$95.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$672.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$815.05
|
| Rate for Payer: Blue Shield of California Commercial |
$1,137.86
|
| Rate for Payer: Blue Shield of California EPN |
$741.89
|
| Rate for Payer: Cash Price |
$809.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: InnovAge PACE Commercial |
$736.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,030.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,030.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Riverside University Health System MISP |
$588.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Adventist Health Commercial |
$294.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,137.86
|
| Rate for Payer: Blue Shield of California EPN |
$741.89
|
| Rate for Payer: Cash Price |
$809.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Senior |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$911.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.44
|
| Rate for Payer: United Healthcare All Other HMO |
$537.72
|
| Rate for Payer: United Healthcare HMO Rider |
$526.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$482.08
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
OP
|
$2,083.02
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.60 |
| Max. Negotiated Rate |
$1,874.72 |
| Rate for Payer: Adventist Health Commercial |
$416.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,145.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,562.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$951.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,153.37
|
| Rate for Payer: Blue Shield of California Commercial |
$1,610.17
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.84
|
| Rate for Payer: Cash Price |
$1,145.66
|
| Rate for Payer: Central Health Plan Commercial |
$1,666.42
|
| Rate for Payer: Cigna of CA HMO |
$1,458.11
|
| Rate for Payer: Cigna of CA PPO |
$1,458.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,770.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,770.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$833.21
|
| Rate for Payer: EPIC Health Plan Senior |
$833.21
|
| Rate for Payer: Galaxy Health WC |
$1,770.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1,249.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,874.72
|
| Rate for Payer: InnovAge PACE Commercial |
$1,041.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,389.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,289.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,458.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,458.11
|
| Rate for Payer: Multiplan Commercial |
$1,562.27
|
| Rate for Payer: Networks By Design Commercial |
$1,041.51
|
| Rate for Payer: Prime Health Services Commercial |
$1,770.57
|
| Rate for Payer: Riverside University Health System MISP |
$833.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,249.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,249.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.76
|
| Rate for Payer: United Healthcare All Other HMO |
$760.93
|
| Rate for Payer: United Healthcare HMO Rider |
$744.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,770.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,770.57
|
| Rate for Payer: Vantage Medical Group Senior |
$1,770.57
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
IP
|
$2,083.02
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$416.60 |
| Max. Negotiated Rate |
$1,874.72 |
| Rate for Payer: Adventist Health Commercial |
$416.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,610.17
|
| Rate for Payer: Blue Shield of California EPN |
$1,049.84
|
| Rate for Payer: Cash Price |
$1,145.66
|
| Rate for Payer: Central Health Plan Commercial |
$1,666.42
|
| Rate for Payer: Cigna of CA HMO |
$1,458.11
|
| Rate for Payer: Cigna of CA PPO |
$1,458.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$833.21
|
| Rate for Payer: EPIC Health Plan Senior |
$833.21
|
| Rate for Payer: Galaxy Health WC |
$1,770.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1,249.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,874.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,389.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$793.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,289.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.60
|
| Rate for Payer: Multiplan Commercial |
$1,562.27
|
| Rate for Payer: Networks By Design Commercial |
$1,041.51
|
| Rate for Payer: Prime Health Services Commercial |
$1,770.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$781.76
|
| Rate for Payer: United Healthcare All Other HMO |
$760.93
|
| Rate for Payer: United Healthcare HMO Rider |
$744.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$682.19
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
OP
|
$1,276.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.34 |
| Max. Negotiated Rate |
$1,149.01 |
| Rate for Payer: Adventist Health Commercial |
$255.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$702.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$957.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$582.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$706.90
|
| Rate for Payer: Blue Shield of California Commercial |
$986.87
|
| Rate for Payer: Blue Shield of California EPN |
$643.45
|
| Rate for Payer: Cash Price |
$702.17
|
| Rate for Payer: Central Health Plan Commercial |
$1,021.34
|
| Rate for Payer: Cigna of CA HMO |
$893.68
|
| Rate for Payer: Cigna of CA PPO |
$893.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,085.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,085.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.67
|
| Rate for Payer: EPIC Health Plan Senior |
$510.67
|
| Rate for Payer: Galaxy Health WC |
$1,085.18
|
| Rate for Payer: Global Benefits Group Commercial |
$766.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.01
|
| Rate for Payer: InnovAge PACE Commercial |
$638.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$851.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$790.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$893.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$893.68
|
| Rate for Payer: Multiplan Commercial |
$957.51
|
| Rate for Payer: Networks By Design Commercial |
$638.34
|
| Rate for Payer: Prime Health Services Commercial |
$1,085.18
|
| Rate for Payer: Riverside University Health System MISP |
$510.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$766.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$766.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.14
|
| Rate for Payer: United Healthcare All Other HMO |
$466.37
|
| Rate for Payer: United Healthcare HMO Rider |
$456.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,085.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,085.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,085.18
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
IP
|
$1,276.68
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.34 |
| Max. Negotiated Rate |
$1,149.01 |
| Rate for Payer: Adventist Health Commercial |
$255.34
|
| Rate for Payer: Blue Shield of California Commercial |
$986.87
|
| Rate for Payer: Blue Shield of California EPN |
$643.45
|
| Rate for Payer: Cash Price |
$702.17
|
| Rate for Payer: Central Health Plan Commercial |
$1,021.34
|
| Rate for Payer: Cigna of CA HMO |
$893.68
|
| Rate for Payer: Cigna of CA PPO |
$893.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$510.67
|
| Rate for Payer: EPIC Health Plan Senior |
$510.67
|
| Rate for Payer: Galaxy Health WC |
$1,085.18
|
| Rate for Payer: Global Benefits Group Commercial |
$766.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$851.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$790.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.34
|
| Rate for Payer: Multiplan Commercial |
$957.51
|
| Rate for Payer: Networks By Design Commercial |
$638.34
|
| Rate for Payer: Prime Health Services Commercial |
$1,085.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$479.14
|
| Rate for Payer: United Healthcare All Other HMO |
$466.37
|
| Rate for Payer: United Healthcare HMO Rider |
$456.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.11
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.79
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
OP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13.53
|
| Rate for Payer: Blue Shield of California EPN |
$8.83
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: InnovAge PACE Commercial |
$11.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$16.61
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Riverside University Health System MISP |
$8.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
IP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Adventist Health Commercial |
$4.43
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Senior |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.61
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.92
|
| Rate for Payer: Blue Shield of California Commercial |
$14.48
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Cigna of CA HMO |
$15.17
|
| Rate for Payer: Cigna of CA PPO |
$17.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: InnovAge PACE Commercial |
$11.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.59
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO |
$11.85
|
| Rate for Payer: United Healthcare HMO Rider |
$11.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.14
|
|
