|
HC CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
OP
|
$521.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.20 |
| 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 |
$442.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$286.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$252.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$307.81
|
| Rate for Payer: Blue Distinction Transplant |
$312.61
|
| Rate for Payer: Blue Shield of California Commercial |
$327.72
|
| Rate for Payer: Blue Shield of California EPN |
$254.77
|
| Rate for Payer: Cash Price |
$234.45
|
| Rate for Payer: Cash Price |
$234.45
|
| Rate for Payer: Central Health Plan Commercial |
$416.81
|
| Rate for Payer: Cigna of CA HMO |
$333.45
|
| Rate for Payer: Cigna of CA PPO |
$385.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.86
|
| Rate for Payer: Dignity Health Media |
$442.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$442.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$208.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$208.40
|
| Rate for Payer: Galaxy Health WC |
$442.86
|
| Rate for Payer: Global Benefits Group Commercial |
$312.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$468.91
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$390.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$347.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.20
|
| Rate for Payer: Multiplan Commercial |
$390.76
|
| Rate for Payer: Networks By Design Commercial |
$338.66
|
| Rate for Payer: Prime Health Services Commercial |
$442.86
|
| Rate for Payer: Riverside University Health System MISP |
$208.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$312.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$312.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$260.50
|
| Rate for Payer: United Healthcare All Other HMO |
$260.50
|
| Rate for Payer: United Healthcare HMO Rider |
$260.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$260.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$442.86
|
| Rate for Payer: Vantage Medical Group Senior |
$442.86
|
|
|
HC CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
IP
|
$521.01
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.20 |
| Max. Negotiated Rate |
$468.91 |
| Rate for Payer: Cash Price |
$234.45
|
| Rate for Payer: Central Health Plan Commercial |
$416.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$208.40
|
| Rate for Payer: Galaxy Health WC |
$442.86
|
| Rate for Payer: Global Benefits Group Commercial |
$312.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$468.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$347.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$104.20
|
| Rate for Payer: Multiplan Commercial |
$390.76
|
| Rate for Payer: Networks By Design Commercial |
$338.66
|
| Rate for Payer: Prime Health Services Commercial |
$442.86
|
|
|
HC CATH CNTRL VNS 4FR
|
Facility
|
OP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$321.34 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$303.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$196.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$196.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$163.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$198.88
|
| Rate for Payer: Blue Distinction Transplant |
$214.23
|
| Rate for Payer: Blue Shield of California Commercial |
$267.79
|
| Rate for Payer: Blue Shield of California EPN |
$194.24
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Central Health Plan Commercial |
$285.64
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$303.49
|
| Rate for Payer: Dignity Health Media |
$303.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$303.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$321.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$267.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.41
|
| Rate for Payer: Multiplan Commercial |
$267.79
|
| Rate for Payer: Networks By Design Commercial |
$178.52
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: Riverside University Health System MISP |
$142.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$214.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$214.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$178.52
|
| Rate for Payer: United Healthcare All Other HMO |
$178.52
|
| Rate for Payer: United Healthcare HMO Rider |
$178.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$178.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$303.49
|
| Rate for Payer: Vantage Medical Group Senior |
$303.49
|
|
|
HC CATH CNTRL VNS 4FR
|
Facility
|
IP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$321.34 |
| Rate for Payer: Blue Shield of California EPN |
$190.66
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Central Health Plan Commercial |
$285.64
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$321.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.41
|
| Rate for Payer: Multiplan Commercial |
$267.79
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.82
|
| Rate for Payer: United Healthcare All Other HMO |
$131.68
|
| Rate for Payer: United Healthcare HMO Rider |
$128.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.83
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
IP
|
$919.86
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.97 |
| Max. Negotiated Rate |
$827.87 |
| Rate for Payer: Blue Shield of California EPN |
$491.21
|
| Rate for Payer: Cash Price |
$413.94
|
| Rate for Payer: Central Health Plan Commercial |
$735.89
|
| Rate for Payer: Cigna of CA HMO |
$643.90
|
| Rate for Payer: Cigna of CA PPO |
$643.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$367.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$367.94
|
| Rate for Payer: Galaxy Health WC |
$781.88
|
| Rate for Payer: Global Benefits Group Commercial |
$551.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$827.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.97
|
| Rate for Payer: Multiplan Commercial |
$689.90
|
| Rate for Payer: Prime Health Services Commercial |
$781.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.34
|
| Rate for Payer: United Healthcare All Other HMO |
$339.24
|
| Rate for Payer: United Healthcare HMO Rider |
$331.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.55
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
OP
|
$919.86
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.97 |
| Max. Negotiated Rate |
$827.87 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$781.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$505.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$505.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$420.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$512.36
|
| Rate for Payer: Blue Distinction Transplant |
$551.92
|
| Rate for Payer: Blue Shield of California Commercial |
$689.90
|
| Rate for Payer: Blue Shield of California EPN |
$500.40
|
| Rate for Payer: Cash Price |
$413.94
|
| Rate for Payer: Central Health Plan Commercial |
$735.89
|
| Rate for Payer: Cigna of CA HMO |
$643.90
|
| Rate for Payer: Cigna of CA PPO |
$643.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$781.88
|
| Rate for Payer: Dignity Health Media |
$781.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$781.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$367.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$367.94
|
| Rate for Payer: Galaxy Health WC |
$781.88
|
| Rate for Payer: Global Benefits Group Commercial |
$551.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$827.87
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$689.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$321.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.97
|
| Rate for Payer: Multiplan Commercial |
$689.90
|
| Rate for Payer: Networks By Design Commercial |
$459.93
|
| Rate for Payer: Prime Health Services Commercial |
$781.88
|
| Rate for Payer: Riverside University Health System MISP |
$367.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$551.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$551.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$459.93
|
| Rate for Payer: United Healthcare All Other HMO |
$459.93
|
| Rate for Payer: United Healthcare HMO Rider |
$459.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$459.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$781.88
|
| Rate for Payer: Vantage Medical Group Senior |
$781.88
|
|
|
HC CATH CNTRL VNS 5FR
|
Facility
|
OP
|
$267.33
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$240.60 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$227.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.90
|
| Rate for Payer: Blue Distinction Transplant |
$160.40
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$145.43
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Central Health Plan Commercial |
$213.86
|
| Rate for Payer: Cigna of CA HMO |
$187.13
|
| Rate for Payer: Cigna of CA PPO |
$187.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$227.23
|
| Rate for Payer: Dignity Health Media |
$227.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$227.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.93
|
| Rate for Payer: Galaxy Health WC |
$227.23
|
| Rate for Payer: Global Benefits Group Commercial |
$160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$200.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$93.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.47
|
| Rate for Payer: Multiplan Commercial |
$200.50
|
| Rate for Payer: Networks By Design Commercial |
$133.66
|
| Rate for Payer: Prime Health Services Commercial |
$227.23
|
| Rate for Payer: Riverside University Health System MISP |
$106.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$133.66
|
| Rate for Payer: United Healthcare All Other HMO |
$133.66
|
| Rate for Payer: United Healthcare HMO Rider |
$133.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$133.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$227.23
|
| Rate for Payer: Vantage Medical Group Senior |
$227.23
|
|
|
HC CATH CNTRL VNS 5FR
|
Facility
|
IP
|
$267.33
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.47 |
| Max. Negotiated Rate |
$240.60 |
| Rate for Payer: Blue Shield of California EPN |
$142.75
|
| Rate for Payer: Cash Price |
$120.30
|
| Rate for Payer: Central Health Plan Commercial |
$213.86
|
| Rate for Payer: Cigna of CA HMO |
$187.13
|
| Rate for Payer: Cigna of CA PPO |
$187.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.93
|
| Rate for Payer: Galaxy Health WC |
$227.23
|
| Rate for Payer: Global Benefits Group Commercial |
$160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.47
|
| Rate for Payer: Multiplan Commercial |
$200.50
|
| Rate for Payer: Prime Health Services Commercial |
$227.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.94
|
| Rate for Payer: United Healthcare All Other HMO |
$98.59
|
| Rate for Payer: United Healthcare HMO Rider |
$96.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.22
|
|
|
HC CATH CNTRL VNS 5FR8CM DL BRK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| 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: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: 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 Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH CNTRL VNS 5FR8CM DL BRK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH CNTRL VNS 7FR TL
|
Facility
|
IP
|
$222.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$199.90 |
| Rate for Payer: Cash Price |
$99.95
|
| Rate for Payer: Central Health Plan Commercial |
$177.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.84
|
| Rate for Payer: Galaxy Health WC |
$188.79
|
| Rate for Payer: Global Benefits Group Commercial |
$133.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.42
|
| Rate for Payer: Multiplan Commercial |
$166.58
|
| Rate for Payer: Networks By Design Commercial |
$144.37
|
| Rate for Payer: Prime Health Services Commercial |
$188.79
|
|
|
HC CATH CNTRL VNS 7FR TL
|
Facility
|
OP
|
$222.11
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.42 |
| 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 |
$188.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$122.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$122.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$131.22
|
| Rate for Payer: Blue Distinction Transplant |
$133.27
|
| Rate for Payer: Blue Shield of California Commercial |
$139.71
|
| Rate for Payer: Blue Shield of California EPN |
$108.61
|
| Rate for Payer: Cash Price |
$99.95
|
| Rate for Payer: Cash Price |
$99.95
|
| Rate for Payer: Central Health Plan Commercial |
$177.69
|
| Rate for Payer: Cigna of CA HMO |
$142.15
|
| Rate for Payer: Cigna of CA PPO |
$164.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.79
|
| Rate for Payer: Dignity Health Media |
$188.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$88.84
|
| Rate for Payer: Galaxy Health WC |
$188.79
|
| Rate for Payer: Global Benefits Group Commercial |
$133.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$166.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$77.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.42
|
| Rate for Payer: Multiplan Commercial |
$166.58
|
| Rate for Payer: Networks By Design Commercial |
$144.37
|
| Rate for Payer: Prime Health Services Commercial |
$188.79
|
| Rate for Payer: Riverside University Health System MISP |
$88.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.06
|
| Rate for Payer: United Healthcare All Other HMO |
$111.06
|
| Rate for Payer: United Healthcare HMO Rider |
$111.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$111.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.79
|
| Rate for Payer: Vantage Medical Group Senior |
$188.79
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
OP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$2,532.15 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,391.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,547.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,547.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,284.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,567.12
|
| Rate for Payer: Blue Distinction Transplant |
$1,688.10
|
| Rate for Payer: Blue Shield of California Commercial |
$2,110.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,530.54
|
| Rate for Payer: Cash Price |
$1,266.08
|
| Rate for Payer: Central Health Plan Commercial |
$2,250.80
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,391.48
|
| Rate for Payer: Dignity Health Media |
$2,391.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,391.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.48
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,532.15
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,110.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$984.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$562.70
|
| Rate for Payer: Multiplan Commercial |
$2,110.12
|
| Rate for Payer: Networks By Design Commercial |
$1,406.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.48
|
| Rate for Payer: Riverside University Health System MISP |
$1,125.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,688.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,688.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,406.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,406.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,406.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,406.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,391.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2,391.48
|
|
|
HC CATH CNTRL VNS 8.5FRX20 PRESEP
|
Facility
|
IP
|
$2,813.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.70 |
| Max. Negotiated Rate |
$2,532.15 |
| Rate for Payer: Blue Shield of California EPN |
$1,502.41
|
| Rate for Payer: Cash Price |
$1,266.08
|
| Rate for Payer: Central Health Plan Commercial |
$2,250.80
|
| Rate for Payer: Cigna of CA HMO |
$1,969.45
|
| Rate for Payer: Cigna of CA PPO |
$1,969.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,125.40
|
| Rate for Payer: Galaxy Health WC |
$2,391.48
|
| Rate for Payer: Global Benefits Group Commercial |
$1,688.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,532.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,876.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,071.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$562.70
|
| Rate for Payer: Multiplan Commercial |
$2,110.12
|
| Rate for Payer: Prime Health Services Commercial |
$2,391.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,062.38
|
| Rate for Payer: United Healthcare All Other HMO |
$1,037.62
|
| Rate for Payer: United Healthcare HMO Rider |
$1,015.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$928.46
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
OP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$1,119.79 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$684.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$684.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$568.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$693.02
|
| Rate for Payer: Blue Distinction Transplant |
$746.53
|
| Rate for Payer: Blue Shield of California Commercial |
$933.16
|
| Rate for Payer: Blue Shield of California EPN |
$676.85
|
| Rate for Payer: Cash Price |
$559.89
|
| Rate for Payer: Central Health Plan Commercial |
$995.37
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,057.58
|
| Rate for Payer: Dignity Health Media |
$1,057.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,057.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,119.79
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$933.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$435.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.84
|
| Rate for Payer: Multiplan Commercial |
$933.16
|
| Rate for Payer: Networks By Design Commercial |
$622.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: Riverside University Health System MISP |
$497.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$746.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$746.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$622.10
|
| Rate for Payer: United Healthcare All Other HMO |
$622.10
|
| Rate for Payer: United Healthcare HMO Rider |
$622.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$622.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,057.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,057.58
|
|
|
HC CATH CNTRL VNS 8FRX 20 PRESEP
|
Facility
|
IP
|
$1,244.21
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$248.84 |
| Max. Negotiated Rate |
$1,119.79 |
| Rate for Payer: Blue Shield of California EPN |
$664.41
|
| Rate for Payer: Cash Price |
$559.89
|
| Rate for Payer: Central Health Plan Commercial |
$995.37
|
| Rate for Payer: Cigna of CA HMO |
$870.95
|
| Rate for Payer: Cigna of CA PPO |
$870.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.68
|
| Rate for Payer: Galaxy Health WC |
$1,057.58
|
| Rate for Payer: Global Benefits Group Commercial |
$746.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,119.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.84
|
| Rate for Payer: Multiplan Commercial |
$933.16
|
| Rate for Payer: Prime Health Services Commercial |
$1,057.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$469.81
|
| Rate for Payer: United Healthcare All Other HMO |
$458.86
|
| Rate for Payer: United Healthcare HMO Rider |
$448.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$410.59
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
IP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$197.82 |
| Rate for Payer: Cash Price |
$98.91
|
| Rate for Payer: Central Health Plan Commercial |
$175.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.96
|
| Rate for Payer: Multiplan Commercial |
$164.85
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
|
|
HC CATH CNTRL VNS DBL LUMEN
|
Facility
|
OP
|
$219.80
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603561
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.96 |
| 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 |
$186.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$120.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.86
|
| Rate for Payer: Blue Distinction Transplant |
$131.88
|
| Rate for Payer: Blue Shield of California Commercial |
$138.25
|
| Rate for Payer: Blue Shield of California EPN |
$107.48
|
| Rate for Payer: Cash Price |
$98.91
|
| Rate for Payer: Cash Price |
$98.91
|
| Rate for Payer: Central Health Plan Commercial |
$175.84
|
| Rate for Payer: Cigna of CA HMO |
$140.67
|
| Rate for Payer: Cigna of CA PPO |
$162.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.83
|
| Rate for Payer: Dignity Health Media |
$186.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$87.92
|
| Rate for Payer: Galaxy Health WC |
$186.83
|
| Rate for Payer: Global Benefits Group Commercial |
$131.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$164.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$76.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.96
|
| Rate for Payer: Multiplan Commercial |
$164.85
|
| Rate for Payer: Networks By Design Commercial |
$142.87
|
| Rate for Payer: Prime Health Services Commercial |
$186.83
|
| Rate for Payer: Riverside University Health System MISP |
$87.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.90
|
| Rate for Payer: United Healthcare All Other HMO |
$109.90
|
| Rate for Payer: United Healthcare HMO Rider |
$109.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.83
|
| Rate for Payer: Vantage Medical Group Senior |
$186.83
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,265.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,050.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,281.10
|
| Rate for Payer: Blue Distinction Transplant |
$1,380.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,725.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Media |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,725.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH CNTRL VNS HCKMN RPR 9.5F
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Blue Shield of California EPN |
$1,228.20
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$868.48
|
| Rate for Payer: United Healthcare All Other HMO |
$848.24
|
| Rate for Payer: United Healthcare HMO Rider |
$829.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$759.00
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
OP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| 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 |
$534.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$346.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$371.70
|
| Rate for Payer: Blue Distinction Transplant |
$377.48
|
| Rate for Payer: Blue Shield of California Commercial |
$395.73
|
| Rate for Payer: Blue Shield of California EPN |
$307.65
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: Cigna of CA HMO |
$402.65
|
| Rate for Payer: Cigna of CA PPO |
$465.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.77
|
| Rate for Payer: Dignity Health Media |
$534.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$534.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$471.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$220.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
| Rate for Payer: Riverside University Health System MISP |
$251.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$377.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$377.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$314.57
|
| Rate for Payer: United Healthcare All Other HMO |
$314.57
|
| Rate for Payer: United Healthcare HMO Rider |
$314.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$534.77
|
| Rate for Payer: Vantage Medical Group Senior |
$534.77
|
|
|
HC CATH CNTRL VNS KIT 5.5FR TL
|
Facility
|
IP
|
$629.14
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$566.23 |
| Rate for Payer: Cash Price |
$283.11
|
| Rate for Payer: Central Health Plan Commercial |
$503.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$251.66
|
| Rate for Payer: Galaxy Health WC |
$534.77
|
| Rate for Payer: Global Benefits Group Commercial |
$377.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$566.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$419.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.83
|
| Rate for Payer: Multiplan Commercial |
$471.86
|
| Rate for Payer: Networks By Design Commercial |
$408.94
|
| Rate for Payer: Prime Health Services Commercial |
$534.77
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698636
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
OP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$232.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$192.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$235.19
|
| Rate for Payer: Blue Distinction Transplant |
$253.34
|
| Rate for Payer: Blue Shield of California Commercial |
$316.68
|
| Rate for Payer: Blue Shield of California EPN |
$229.70
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$358.90
|
| Rate for Payer: Dignity Health Media |
$358.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$316.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$147.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: Riverside University Health System MISP |
$168.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.12
|
| Rate for Payer: United Healthcare All Other HMO |
$211.12
|
| Rate for Payer: United Healthcare HMO Rider |
$211.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.90
|
| Rate for Payer: Vantage Medical Group Senior |
$358.90
|
|
|
HC CATH CNTRL VNS PEDS 4FR 2LUMEN
|
Facility
|
IP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Blue Shield of California EPN |
$225.48
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.44
|
| Rate for Payer: United Healthcare All Other HMO |
$155.72
|
| Rate for Payer: United Healthcare HMO Rider |
$152.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$139.34
|
|
