|
HC CATH AIRWAY EXCHANGE 8FR
|
Facility
|
IP
|
$377.81
|
|
| Hospital Charge Code |
901603693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$340.03 |
| Rate for Payer: Cash Price |
$170.01
|
| Rate for Payer: Central Health Plan Commercial |
$302.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.12
|
| Rate for Payer: Galaxy Health WC |
$321.14
|
| Rate for Payer: Global Benefits Group Commercial |
$226.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$340.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$252.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.56
|
| Rate for Payer: Multiplan Commercial |
$283.36
|
| Rate for Payer: Networks By Design Commercial |
$245.58
|
| Rate for Payer: Prime Health Services Commercial |
$321.14
|
|
|
HC CATH ARGON T/D BAL
|
Facility
|
IP
|
$537.37
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906811756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.47 |
| Max. Negotiated Rate |
$483.63 |
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Central Health Plan Commercial |
$429.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.95
|
| Rate for Payer: Galaxy Health WC |
$456.76
|
| Rate for Payer: Global Benefits Group Commercial |
$322.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$483.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.47
|
| Rate for Payer: Multiplan Commercial |
$403.03
|
| Rate for Payer: Networks By Design Commercial |
$349.29
|
| Rate for Payer: Prime Health Services Commercial |
$456.76
|
|
|
HC CATH ARGON T/D BAL
|
Facility
|
OP
|
$537.37
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906811756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.47 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$295.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$260.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$317.48
|
| Rate for Payer: Blue Distinction Transplant |
$322.42
|
| Rate for Payer: Blue Shield of California Commercial |
$338.01
|
| Rate for Payer: Blue Shield of California EPN |
$262.77
|
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Central Health Plan Commercial |
$429.90
|
| Rate for Payer: Cigna of CA HMO |
$343.92
|
| Rate for Payer: Cigna of CA PPO |
$397.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.76
|
| Rate for Payer: Dignity Health Media |
$456.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$456.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$214.95
|
| Rate for Payer: Galaxy Health WC |
$456.76
|
| Rate for Payer: Global Benefits Group Commercial |
$322.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$483.63
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$403.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$188.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.47
|
| Rate for Payer: Multiplan Commercial |
$403.03
|
| Rate for Payer: Networks By Design Commercial |
$349.29
|
| Rate for Payer: Prime Health Services Commercial |
$456.76
|
| Rate for Payer: Riverside University Health System MISP |
$214.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$322.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$322.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.68
|
| Rate for Payer: United Healthcare All Other HMO |
$268.68
|
| Rate for Payer: United Healthcare HMO Rider |
$268.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$268.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$456.76
|
| Rate for Payer: Vantage Medical Group Senior |
$456.76
|
|
|
HC CATH ARROW ANGIO BAL
|
Facility
|
IP
|
$247.87
|
|
| Hospital Charge Code |
906812007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.57 |
| Max. Negotiated Rate |
$223.08 |
| Rate for Payer: Cash Price |
$111.54
|
| Rate for Payer: Central Health Plan Commercial |
$198.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.15
|
| Rate for Payer: Galaxy Health WC |
$210.69
|
| Rate for Payer: Global Benefits Group Commercial |
$148.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.57
|
| Rate for Payer: Multiplan Commercial |
$185.90
|
| Rate for Payer: Networks By Design Commercial |
$161.12
|
| Rate for Payer: Prime Health Services Commercial |
$210.69
|
|
|
HC CATH ARROW ANGIO BAL
|
Facility
|
OP
|
$247.87
|
|
| Hospital Charge Code |
906812007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.57 |
| Max. Negotiated Rate |
$223.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$150.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$210.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$136.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.44
|
| Rate for Payer: Blue Distinction Transplant |
$148.72
|
| Rate for Payer: Blue Shield of California Commercial |
$155.91
|
| Rate for Payer: Blue Shield of California EPN |
$121.21
|
| Rate for Payer: Cash Price |
$111.54
|
| Rate for Payer: Central Health Plan Commercial |
$198.30
|
| Rate for Payer: Cigna of CA HMO |
$158.64
|
| Rate for Payer: Cigna of CA PPO |
$183.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$210.69
|
| Rate for Payer: Dignity Health Media |
$210.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$210.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$99.15
|
| Rate for Payer: Galaxy Health WC |
$210.69
|
| Rate for Payer: Global Benefits Group Commercial |
$148.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.08
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$185.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$86.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.57
|
| Rate for Payer: Multiplan Commercial |
$185.90
|
| Rate for Payer: Networks By Design Commercial |
$161.12
|
| Rate for Payer: Prime Health Services Commercial |
$210.69
|
| Rate for Payer: Riverside University Health System MISP |
$99.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.94
|
| Rate for Payer: United Healthcare All Other HMO |
$123.94
|
| Rate for Payer: United Healthcare HMO Rider |
$123.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$210.69
|
| Rate for Payer: Vantage Medical Group Senior |
$210.69
|
|
|
HC CATH ARROW T/D BAL
|
Facility
|
OP
|
$334.04
|
|
| Hospital Charge Code |
906812009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.81 |
| Max. Negotiated Rate |
$300.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$202.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$283.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$183.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$183.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$161.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.35
|
| Rate for Payer: Blue Distinction Transplant |
$200.42
|
| Rate for Payer: Blue Shield of California Commercial |
$210.11
|
| Rate for Payer: Blue Shield of California EPN |
$163.35
|
| Rate for Payer: Cash Price |
$150.32
|
| Rate for Payer: Central Health Plan Commercial |
$267.23
|
| Rate for Payer: Cigna of CA HMO |
$213.79
|
| Rate for Payer: Cigna of CA PPO |
$247.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$283.93
|
| Rate for Payer: Dignity Health Media |
$283.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$133.62
|
| Rate for Payer: Galaxy Health WC |
$283.93
|
| Rate for Payer: Global Benefits Group Commercial |
$200.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$300.64
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$250.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.81
|
| Rate for Payer: Multiplan Commercial |
$250.53
|
| Rate for Payer: Networks By Design Commercial |
$217.13
|
| Rate for Payer: Prime Health Services Commercial |
$283.93
|
| Rate for Payer: Riverside University Health System MISP |
$133.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$167.02
|
| Rate for Payer: United Healthcare All Other HMO |
$167.02
|
| Rate for Payer: United Healthcare HMO Rider |
$167.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$167.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.93
|
| Rate for Payer: Vantage Medical Group Senior |
$283.93
|
|
|
HC CATH ARROW T/D BAL
|
Facility
|
IP
|
$334.04
|
|
| Hospital Charge Code |
906812009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.81 |
| Max. Negotiated Rate |
$300.64 |
| Rate for Payer: Cash Price |
$150.32
|
| Rate for Payer: Central Health Plan Commercial |
$267.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.62
|
| Rate for Payer: Galaxy Health WC |
$283.93
|
| Rate for Payer: Global Benefits Group Commercial |
$200.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$300.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.81
|
| Rate for Payer: Multiplan Commercial |
$250.53
|
| Rate for Payer: Networks By Design Commercial |
$217.13
|
| Rate for Payer: Prime Health Services Commercial |
$283.93
|
|
|
HC CATH ARROW T/D BAL 6FR 110CM
|
Facility
|
OP
|
$563.00
|
|
| Hospital Charge Code |
906812367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$341.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$478.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$309.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$272.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$332.62
|
| Rate for Payer: Blue Distinction Transplant |
$337.80
|
| Rate for Payer: Blue Shield of California Commercial |
$354.13
|
| Rate for Payer: Blue Shield of California EPN |
$275.31
|
| Rate for Payer: Cash Price |
$253.35
|
| Rate for Payer: Central Health Plan Commercial |
$450.40
|
| Rate for Payer: Cigna of CA HMO |
$360.32
|
| Rate for Payer: Cigna of CA PPO |
$416.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$478.55
|
| Rate for Payer: Dignity Health Media |
$478.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$478.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$225.20
|
| Rate for Payer: Galaxy Health WC |
$478.55
|
| Rate for Payer: Global Benefits Group Commercial |
$337.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$506.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$422.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$375.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.60
|
| Rate for Payer: Multiplan Commercial |
$422.25
|
| Rate for Payer: Networks By Design Commercial |
$365.95
|
| Rate for Payer: Prime Health Services Commercial |
$478.55
|
| Rate for Payer: Riverside University Health System MISP |
$225.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$337.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$337.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$281.50
|
| Rate for Payer: United Healthcare All Other HMO |
$281.50
|
| Rate for Payer: United Healthcare HMO Rider |
$281.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$478.55
|
| Rate for Payer: Vantage Medical Group Senior |
$478.55
|
|
|
HC CATH ARROW T/D BAL 6FR 110CM
|
Facility
|
IP
|
$563.00
|
|
| Hospital Charge Code |
906812367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Cash Price |
$253.35
|
| Rate for Payer: Central Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.20
|
| Rate for Payer: Galaxy Health WC |
$478.55
|
| Rate for Payer: Global Benefits Group Commercial |
$337.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$506.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$375.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.60
|
| Rate for Payer: Multiplan Commercial |
$422.25
|
| Rate for Payer: Networks By Design Commercial |
$365.95
|
| Rate for Payer: Prime Health Services Commercial |
$478.55
|
|
|
HC CATH, ARROW-TRETOTOLA THROMBOL
|
Facility
|
IP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Blue Shield of California EPN |
$768.96
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,152.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,296.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$548.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$543.74
|
| Rate for Payer: United Healthcare All Other HMO |
$531.07
|
| Rate for Payer: United Healthcare HMO Rider |
$519.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$475.20
|
|
|
HC CATH, ARROW-TRETOTOLA THROMBOL
|
Facility
|
OP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$792.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$792.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$657.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$802.08
|
| Rate for Payer: Blue Distinction Transplant |
$864.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,080.00
|
| Rate for Payer: Blue Shield of California EPN |
$783.36
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,152.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Dignity Health Media |
$1,224.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,224.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,296.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,080.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$504.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$548.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Networks By Design Commercial |
$720.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: Riverside University Health System MISP |
$576.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$864.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$864.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Other HMO |
$720.00
|
| Rate for Payer: United Healthcare HMO Rider |
$720.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$720.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,224.00
|
|
|
HC CATH ARROW TWO-LUMEN CVP 9FR
|
Facility
|
OP
|
$566.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$509.40 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$481.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$311.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$258.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$315.26
|
| Rate for Payer: Blue Distinction Transplant |
$339.60
|
| Rate for Payer: Blue Shield of California Commercial |
$424.50
|
| Rate for Payer: Blue Shield of California EPN |
$307.90
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Central Health Plan Commercial |
$452.80
|
| Rate for Payer: Cigna of CA HMO |
$396.20
|
| Rate for Payer: Cigna of CA PPO |
$396.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$481.10
|
| Rate for Payer: Dignity Health Media |
$481.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$481.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$226.40
|
| Rate for Payer: Galaxy Health WC |
$481.10
|
| Rate for Payer: Global Benefits Group Commercial |
$339.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$509.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$424.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$377.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.20
|
| Rate for Payer: Multiplan Commercial |
$424.50
|
| Rate for Payer: Networks By Design Commercial |
$283.00
|
| Rate for Payer: Prime Health Services Commercial |
$481.10
|
| Rate for Payer: Riverside University Health System MISP |
$226.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$339.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$339.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$283.00
|
| Rate for Payer: United Healthcare All Other HMO |
$283.00
|
| Rate for Payer: United Healthcare HMO Rider |
$283.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$283.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$481.10
|
| Rate for Payer: Vantage Medical Group Senior |
$481.10
|
|
|
HC CATH ARROW TWO-LUMEN CVP 9FR
|
Facility
|
IP
|
$566.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$509.40 |
| Rate for Payer: Blue Shield of California EPN |
$302.24
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Central Health Plan Commercial |
$452.80
|
| Rate for Payer: Cigna of CA HMO |
$396.20
|
| Rate for Payer: Cigna of CA PPO |
$396.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$226.40
|
| Rate for Payer: Galaxy Health WC |
$481.10
|
| Rate for Payer: Global Benefits Group Commercial |
$339.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$509.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$377.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.20
|
| Rate for Payer: Multiplan Commercial |
$424.50
|
| Rate for Payer: Prime Health Services Commercial |
$481.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$213.72
|
| Rate for Payer: United Healthcare All Other HMO |
$208.74
|
| Rate for Payer: United Healthcare HMO Rider |
$204.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$186.78
|
|
|
HC CATH ARTERIAL 20GA X1-3/4" KIT
|
Facility
|
OP
|
$214.90
|
|
| Hospital Charge Code |
901698169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$193.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$130.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$118.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.96
|
| Rate for Payer: Blue Distinction Transplant |
$128.94
|
| Rate for Payer: Blue Shield of California Commercial |
$135.17
|
| Rate for Payer: Blue Shield of California EPN |
$105.09
|
| Rate for Payer: Cash Price |
$96.71
|
| Rate for Payer: Central Health Plan Commercial |
$171.92
|
| Rate for Payer: Cigna of CA HMO |
$137.54
|
| Rate for Payer: Cigna of CA PPO |
$159.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.66
|
| Rate for Payer: Dignity Health Media |
$182.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.96
|
| Rate for Payer: Galaxy Health WC |
$182.66
|
| Rate for Payer: Global Benefits Group Commercial |
$128.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.41
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$161.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$75.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$143.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.98
|
| Rate for Payer: Multiplan Commercial |
$161.18
|
| Rate for Payer: Networks By Design Commercial |
$139.68
|
| Rate for Payer: Prime Health Services Commercial |
$182.66
|
| Rate for Payer: Riverside University Health System MISP |
$85.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.45
|
| Rate for Payer: United Healthcare All Other HMO |
$107.45
|
| Rate for Payer: United Healthcare HMO Rider |
$107.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.66
|
| Rate for Payer: Vantage Medical Group Senior |
$182.66
|
|
|
HC CATH ARTERIAL 20GA X1-3/4" KIT
|
Facility
|
IP
|
$214.90
|
|
| Hospital Charge Code |
901698169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$193.41 |
| Rate for Payer: Cash Price |
$96.71
|
| Rate for Payer: Central Health Plan Commercial |
$171.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.96
|
| Rate for Payer: Galaxy Health WC |
$182.66
|
| Rate for Payer: Global Benefits Group Commercial |
$128.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$143.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.98
|
| Rate for Payer: Multiplan Commercial |
$161.18
|
| Rate for Payer: Networks By Design Commercial |
$139.68
|
| Rate for Payer: Prime Health Services Commercial |
$182.66
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
IP
|
$203.00
|
|
| Hospital Charge Code |
901698701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Central Health Plan Commercial |
$162.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$182.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.60
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
IP
|
$318.29
|
|
| Hospital Charge Code |
901607626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$286.46 |
| Rate for Payer: Cash Price |
$143.23
|
| Rate for Payer: Central Health Plan Commercial |
$254.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.32
|
| Rate for Payer: Galaxy Health WC |
$270.55
|
| Rate for Payer: Global Benefits Group Commercial |
$190.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$286.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$212.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.66
|
| Rate for Payer: Multiplan Commercial |
$238.72
|
| Rate for Payer: Networks By Design Commercial |
$206.89
|
| Rate for Payer: Prime Health Services Commercial |
$270.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
OP
|
$318.29
|
|
| Hospital Charge Code |
901607626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$286.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$193.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$270.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$154.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.05
|
| Rate for Payer: Blue Distinction Transplant |
$190.97
|
| Rate for Payer: Blue Shield of California Commercial |
$200.20
|
| Rate for Payer: Blue Shield of California EPN |
$155.64
|
| Rate for Payer: Cash Price |
$143.23
|
| Rate for Payer: Central Health Plan Commercial |
$254.63
|
| Rate for Payer: Cigna of CA HMO |
$203.71
|
| Rate for Payer: Cigna of CA PPO |
$235.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$270.55
|
| Rate for Payer: Dignity Health Media |
$270.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$270.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$127.32
|
| Rate for Payer: Galaxy Health WC |
$270.55
|
| Rate for Payer: Global Benefits Group Commercial |
$190.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$286.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$238.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$111.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$212.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.66
|
| Rate for Payer: Multiplan Commercial |
$238.72
|
| Rate for Payer: Networks By Design Commercial |
$206.89
|
| Rate for Payer: Prime Health Services Commercial |
$270.55
|
| Rate for Payer: Riverside University Health System MISP |
$127.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$190.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$190.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.14
|
| Rate for Payer: United Healthcare All Other HMO |
$159.14
|
| Rate for Payer: United Healthcare HMO Rider |
$159.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$270.55
|
| Rate for Payer: Vantage Medical Group Senior |
$270.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
OP
|
$203.00
|
|
| Hospital Charge Code |
901698701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$172.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$111.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.93
|
| Rate for Payer: Blue Distinction Transplant |
$121.80
|
| Rate for Payer: Blue Shield of California Commercial |
$127.69
|
| Rate for Payer: Blue Shield of California EPN |
$99.27
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Central Health Plan Commercial |
$162.40
|
| Rate for Payer: Cigna of CA HMO |
$129.92
|
| Rate for Payer: Cigna of CA PPO |
$150.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$172.55
|
| Rate for Payer: Dignity Health Media |
$172.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$172.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$182.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$152.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$71.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.60
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
| Rate for Payer: Riverside University Health System MISP |
$81.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.50
|
| Rate for Payer: United Healthcare All Other HMO |
$101.50
|
| Rate for Payer: United Healthcare HMO Rider |
$101.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$172.55
|
| Rate for Payer: Vantage Medical Group Senior |
$172.55
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.80
|
| Rate for Payer: Blue Distinction Transplant |
$91.20
|
| Rate for Payer: Blue Shield of California Commercial |
$95.61
|
| Rate for Payer: Blue Shield of California EPN |
$74.33
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Media |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$114.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
IP
|
$129.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.84 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Central Health Plan Commercial |
$103.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.68
|
| Rate for Payer: Galaxy Health WC |
$109.82
|
| Rate for Payer: Global Benefits Group Commercial |
$77.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.84
|
| Rate for Payer: Multiplan Commercial |
$96.90
|
| Rate for Payer: Networks By Design Commercial |
$83.98
|
| Rate for Payer: Prime Health Services Commercial |
$109.82
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
OP
|
$129.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.84 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$109.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.33
|
| Rate for Payer: Blue Distinction Transplant |
$77.52
|
| Rate for Payer: Blue Shield of California Commercial |
$81.27
|
| Rate for Payer: Blue Shield of California EPN |
$63.18
|
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Central Health Plan Commercial |
$103.36
|
| Rate for Payer: Cigna of CA HMO |
$82.69
|
| Rate for Payer: Cigna of CA PPO |
$95.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.82
|
| Rate for Payer: Dignity Health Media |
$109.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$109.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.68
|
| Rate for Payer: Galaxy Health WC |
$109.82
|
| Rate for Payer: Global Benefits Group Commercial |
$77.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.28
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$96.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.84
|
| Rate for Payer: Multiplan Commercial |
$96.90
|
| Rate for Payer: Networks By Design Commercial |
$83.98
|
| Rate for Payer: Prime Health Services Commercial |
$109.82
|
| Rate for Payer: Riverside University Health System MISP |
$51.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.60
|
| Rate for Payer: United Healthcare All Other HMO |
$64.60
|
| Rate for Payer: United Healthcare HMO Rider |
$64.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.82
|
| Rate for Payer: Vantage Medical Group Senior |
$109.82
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
OP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$23,685.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,685.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,605.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,605.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,293.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,798.92
|
| Rate for Payer: Blue Distinction Transplant |
$2,842.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,979.89
|
| Rate for Payer: Blue Shield of California EPN |
$2,316.64
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: Cigna of CA HMO |
$3,032.00
|
| Rate for Payer: Cigna of CA PPO |
$3,505.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Dignity Health Media |
$4,026.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,026.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,553.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,658.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
| Rate for Payer: Riverside University Health System MISP |
$1,895.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,842.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,026.88
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
IP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,263.75 |
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,263.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$947.50
|
| Rate for Payer: Multiplan Commercial |
$3,553.12
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
|
