|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
IP
|
$898.20
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.64 |
| Max. Negotiated Rate |
$808.38 |
| Rate for Payer: Cash Price |
$404.19
|
| Rate for Payer: Central Health Plan Commercial |
$718.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.28
|
| Rate for Payer: Galaxy Health WC |
$763.47
|
| Rate for Payer: Global Benefits Group Commercial |
$538.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$599.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.64
|
| Rate for Payer: Multiplan Commercial |
$673.65
|
| Rate for Payer: Networks By Design Commercial |
$583.83
|
| Rate for Payer: Prime Health Services Commercial |
$763.47
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
OP
|
$898.20
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.64 |
| Max. Negotiated Rate |
$808.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$545.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$763.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$494.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$434.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.66
|
| Rate for Payer: Blue Distinction Transplant |
$538.92
|
| Rate for Payer: Blue Shield of California Commercial |
$564.97
|
| Rate for Payer: Blue Shield of California EPN |
$439.22
|
| Rate for Payer: Cash Price |
$404.19
|
| Rate for Payer: Central Health Plan Commercial |
$718.56
|
| Rate for Payer: Cigna of CA HMO |
$574.85
|
| Rate for Payer: Cigna of CA PPO |
$664.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$763.47
|
| Rate for Payer: Dignity Health Media |
$763.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$359.28
|
| Rate for Payer: Galaxy Health WC |
$763.47
|
| Rate for Payer: Global Benefits Group Commercial |
$538.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$673.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$599.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.64
|
| Rate for Payer: Multiplan Commercial |
$673.65
|
| Rate for Payer: Networks By Design Commercial |
$583.83
|
| Rate for Payer: Prime Health Services Commercial |
$763.47
|
| Rate for Payer: Riverside University Health System MISP |
$359.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$538.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$538.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$449.10
|
| Rate for Payer: United Healthcare All Other HMO |
$449.10
|
| Rate for Payer: United Healthcare HMO Rider |
$449.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$449.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.47
|
| Rate for Payer: Vantage Medical Group Senior |
$763.47
|
|
|
HC CATH CV 7FR 6" TL FULL TRAY
|
Facility
|
OP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$333.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$333.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$276.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.26
|
| Rate for Payer: Blue Distinction Transplant |
$363.30
|
| Rate for Payer: Blue Shield of California Commercial |
$454.12
|
| Rate for Payer: Blue Shield of California EPN |
$329.39
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.68
|
| Rate for Payer: Dignity Health Media |
$514.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.68
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$454.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$211.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.68
|
| Rate for Payer: Riverside University Health System MISP |
$242.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.75
|
| Rate for Payer: United Healthcare All Other HMO |
$302.75
|
| Rate for Payer: United Healthcare HMO Rider |
$302.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.68
|
| Rate for Payer: Vantage Medical Group Senior |
$514.68
|
|
|
HC CATH CV 7FR 6" TL FULL TRAY
|
Facility
|
IP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Blue Shield of California EPN |
$323.34
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.68
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Prime Health Services Commercial |
$514.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.64
|
| Rate for Payer: United Healthcare All Other HMO |
$223.31
|
| Rate for Payer: United Healthcare HMO Rider |
$218.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.82
|
|
|
HC CATH CV 7FR 8" TL FULL TRAY
|
Facility
|
OP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$333.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$333.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$276.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.26
|
| Rate for Payer: Blue Distinction Transplant |
$363.30
|
| Rate for Payer: Blue Shield of California Commercial |
$454.12
|
| Rate for Payer: Blue Shield of California EPN |
$329.39
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.68
|
| Rate for Payer: Dignity Health Media |
$514.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.68
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$454.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$211.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Networks By Design Commercial |
$302.75
|
| Rate for Payer: Prime Health Services Commercial |
$514.68
|
| Rate for Payer: Riverside University Health System MISP |
$242.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.75
|
| Rate for Payer: United Healthcare All Other HMO |
$302.75
|
| Rate for Payer: United Healthcare HMO Rider |
$302.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.68
|
| Rate for Payer: Vantage Medical Group Senior |
$514.68
|
|
|
HC CATH CV 7FR 8" TL FULL TRAY
|
Facility
|
IP
|
$605.50
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607558
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.10 |
| Max. Negotiated Rate |
$544.95 |
| Rate for Payer: Blue Shield of California EPN |
$323.34
|
| Rate for Payer: Cash Price |
$272.48
|
| Rate for Payer: Central Health Plan Commercial |
$484.40
|
| Rate for Payer: Cigna of CA HMO |
$423.85
|
| Rate for Payer: Cigna of CA PPO |
$423.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$242.20
|
| Rate for Payer: Galaxy Health WC |
$514.68
|
| Rate for Payer: Global Benefits Group Commercial |
$363.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$544.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.10
|
| Rate for Payer: Multiplan Commercial |
$454.12
|
| Rate for Payer: Prime Health Services Commercial |
$514.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.64
|
| Rate for Payer: United Healthcare All Other HMO |
$223.31
|
| Rate for Payer: United Healthcare HMO Rider |
$218.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$199.82
|
|
|
HC CATH CV 8FR 6" DL FULL TRAY
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607562
|
|
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 CV 8FR 6" DL FULL TRAY
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607562
|
|
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 DIALYSIS 13FR 15CM TRIALYSIS CURVED
|
Facility
|
IP
|
$780.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.03 |
| Max. Negotiated Rate |
$702.14 |
| Rate for Payer: Blue Shield of California EPN |
$416.61
|
| Rate for Payer: Cash Price |
$351.07
|
| Rate for Payer: Central Health Plan Commercial |
$624.13
|
| Rate for Payer: Cigna of CA HMO |
$546.11
|
| Rate for Payer: Cigna of CA PPO |
$546.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$312.06
|
| Rate for Payer: Galaxy Health WC |
$663.14
|
| Rate for Payer: Global Benefits Group Commercial |
$468.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$520.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.03
|
| Rate for Payer: Multiplan Commercial |
$585.12
|
| Rate for Payer: Prime Health Services Commercial |
$663.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$294.59
|
| Rate for Payer: United Healthcare All Other HMO |
$287.72
|
| Rate for Payer: United Healthcare HMO Rider |
$281.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$257.45
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED
|
Facility
|
OP
|
$780.16
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$156.03 |
| Max. Negotiated Rate |
$702.14 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$663.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$429.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$429.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$356.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$434.55
|
| Rate for Payer: Blue Distinction Transplant |
$468.10
|
| Rate for Payer: Blue Shield of California Commercial |
$585.12
|
| Rate for Payer: Blue Shield of California EPN |
$424.41
|
| Rate for Payer: Cash Price |
$351.07
|
| Rate for Payer: Central Health Plan Commercial |
$624.13
|
| Rate for Payer: Cigna of CA HMO |
$546.11
|
| Rate for Payer: Cigna of CA PPO |
$546.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$663.14
|
| Rate for Payer: Dignity Health Media |
$663.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$663.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$312.06
|
| Rate for Payer: Galaxy Health WC |
$663.14
|
| Rate for Payer: Global Benefits Group Commercial |
$468.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$585.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$273.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$520.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.03
|
| Rate for Payer: Multiplan Commercial |
$585.12
|
| Rate for Payer: Networks By Design Commercial |
$390.08
|
| Rate for Payer: Prime Health Services Commercial |
$663.14
|
| Rate for Payer: Riverside University Health System MISP |
$312.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$468.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$468.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$390.08
|
| Rate for Payer: United Healthcare All Other HMO |
$390.08
|
| Rate for Payer: United Healthcare HMO Rider |
$390.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$390.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$663.14
|
| Rate for Payer: Vantage Medical Group Senior |
$663.14
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED LEG
|
Facility
|
IP
|
$1,030.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.02 |
| Max. Negotiated Rate |
$927.11 |
| Rate for Payer: Blue Shield of California EPN |
$550.08
|
| Rate for Payer: Cash Price |
$463.55
|
| Rate for Payer: Central Health Plan Commercial |
$824.10
|
| Rate for Payer: Cigna of CA HMO |
$721.08
|
| Rate for Payer: Cigna of CA PPO |
$721.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$412.05
|
| Rate for Payer: Galaxy Health WC |
$875.60
|
| Rate for Payer: Global Benefits Group Commercial |
$618.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.02
|
| Rate for Payer: Multiplan Commercial |
$772.59
|
| Rate for Payer: Prime Health Services Commercial |
$875.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$388.97
|
| Rate for Payer: United Healthcare All Other HMO |
$379.91
|
| Rate for Payer: United Healthcare HMO Rider |
$371.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$339.94
|
|
|
HC CATH DIALYSIS 13FR 15CM TRIALYSIS CURVED LEG
|
Facility
|
OP
|
$1,030.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$206.02 |
| Max. Negotiated Rate |
$927.11 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$875.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$566.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$470.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$573.78
|
| Rate for Payer: Blue Distinction Transplant |
$618.07
|
| Rate for Payer: Blue Shield of California Commercial |
$772.59
|
| Rate for Payer: Blue Shield of California EPN |
$560.39
|
| Rate for Payer: Cash Price |
$463.55
|
| Rate for Payer: Central Health Plan Commercial |
$824.10
|
| Rate for Payer: Cigna of CA HMO |
$721.08
|
| Rate for Payer: Cigna of CA PPO |
$721.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$875.60
|
| Rate for Payer: Dignity Health Media |
$875.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$875.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$412.05
|
| Rate for Payer: Galaxy Health WC |
$875.60
|
| Rate for Payer: Global Benefits Group Commercial |
$618.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$772.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$360.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.02
|
| Rate for Payer: Multiplan Commercial |
$772.59
|
| Rate for Payer: Networks By Design Commercial |
$515.06
|
| Rate for Payer: Prime Health Services Commercial |
$875.60
|
| Rate for Payer: Riverside University Health System MISP |
$412.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$515.06
|
| Rate for Payer: United Healthcare All Other HMO |
$515.06
|
| Rate for Payer: United Healthcare HMO Rider |
$515.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$515.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$875.60
|
| Rate for Payer: Vantage Medical Group Senior |
$875.60
|
|
|
HC CATH DIALYSIS 13FR 20CM TRIALYSIS STRAIGHT LEG
|
Facility
|
OP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$537.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$537.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$446.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.16
|
| Rate for Payer: Blue Distinction Transplant |
$586.17
|
| Rate for Payer: Blue Shield of California Commercial |
$732.71
|
| Rate for Payer: Blue Shield of California EPN |
$531.46
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.86
|
| Rate for Payer: Cigna of CA PPO |
$683.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.41
|
| Rate for Payer: Dignity Health Media |
$830.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$830.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$732.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$341.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$651.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: Riverside University Health System MISP |
$390.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$586.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$586.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$488.48
|
| Rate for Payer: United Healthcare All Other HMO |
$488.48
|
| Rate for Payer: United Healthcare HMO Rider |
$488.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$488.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$830.41
|
| Rate for Payer: Vantage Medical Group Senior |
$830.41
|
|
|
HC CATH DIALYSIS 13FR 20CM TRIALYSIS STRAIGHT LEG
|
Facility
|
IP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.26 |
| Rate for Payer: Blue Shield of California EPN |
$521.69
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.86
|
| Rate for Payer: Cigna of CA PPO |
$683.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$651.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$368.90
|
| Rate for Payer: United Healthcare All Other HMO |
$360.30
|
| Rate for Payer: United Healthcare HMO Rider |
$352.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$322.39
|
|
|
HC CATH DIALYSIS 13FR 24CM TRIALYSIS STRAIGHT
|
Facility
|
IP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.26 |
| Rate for Payer: Blue Shield of California EPN |
$521.69
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.86
|
| Rate for Payer: Cigna of CA PPO |
$683.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$651.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$368.90
|
| Rate for Payer: United Healthcare All Other HMO |
$360.30
|
| Rate for Payer: United Healthcare HMO Rider |
$352.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$322.39
|
|
|
HC CATH DIALYSIS 13FR 24CM TRIALYSIS STRAIGHT
|
Facility
|
OP
|
$976.95
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.39 |
| Max. Negotiated Rate |
$879.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$537.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$537.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$446.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.16
|
| Rate for Payer: Blue Distinction Transplant |
$586.17
|
| Rate for Payer: Blue Shield of California Commercial |
$732.71
|
| Rate for Payer: Blue Shield of California EPN |
$531.46
|
| Rate for Payer: Cash Price |
$439.63
|
| Rate for Payer: Central Health Plan Commercial |
$781.56
|
| Rate for Payer: Cigna of CA HMO |
$683.86
|
| Rate for Payer: Cigna of CA PPO |
$683.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.41
|
| Rate for Payer: Dignity Health Media |
$830.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$830.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$390.78
|
| Rate for Payer: Galaxy Health WC |
$830.41
|
| Rate for Payer: Global Benefits Group Commercial |
$586.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$879.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$732.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$341.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$651.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.39
|
| Rate for Payer: Multiplan Commercial |
$732.71
|
| Rate for Payer: Networks By Design Commercial |
$488.48
|
| Rate for Payer: Prime Health Services Commercial |
$830.41
|
| Rate for Payer: Riverside University Health System MISP |
$390.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$586.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$586.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$488.48
|
| Rate for Payer: United Healthcare All Other HMO |
$488.48
|
| Rate for Payer: United Healthcare HMO Rider |
$488.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$488.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$830.41
|
| Rate for Payer: Vantage Medical Group Senior |
$830.41
|
|
|
HC CATH DIALYSIS CRCT W STNT PLC
|
Facility
|
IP
|
$34,466.00
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
909036903
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,893.20 |
| Max. Negotiated Rate |
$31,019.40 |
| Rate for Payer: Cash Price |
$15,509.70
|
| Rate for Payer: Central Health Plan Commercial |
$27,572.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,786.40
|
| Rate for Payer: Galaxy Health WC |
$29,296.10
|
| Rate for Payer: Global Benefits Group Commercial |
$20,679.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,019.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,988.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,131.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,893.20
|
| Rate for Payer: Multiplan Commercial |
$25,849.50
|
| Rate for Payer: Networks By Design Commercial |
$22,402.90
|
| Rate for Payer: Prime Health Services Commercial |
$29,296.10
|
|
|
HC CATH DIALYSIS CRCT W STNT PLC
|
Facility
|
OP
|
$34,466.00
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
909036903
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$20,679.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$15,509.70
|
| Rate for Payer: Cash Price |
$15,509.70
|
| Rate for Payer: Central Health Plan Commercial |
$27,572.80
|
| Rate for Payer: Cigna of CA PPO |
$25,504.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$29,296.10
|
| Rate for Payer: Global Benefits Group Commercial |
$20,679.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,019.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25,849.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,988.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,832.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,893.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$25,849.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$22,402.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$29,296.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,679.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
OP
|
$14,959.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
906820281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,112.91 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,141.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,975.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,141.35
|
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,967.20
|
| Rate for Payer: Cigna of CA PPO |
$11,069.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$12,715.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,975.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,463.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,219.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,711.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,783.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: InnovAge PACE Commercial |
$10,712.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,977.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,569.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$11,219.25
|
| Rate for Payer: Networks By Design Commercial |
$9,723.35
|
| Rate for Payer: Prime Health Services Commercial |
$12,715.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,569.83
|
| Rate for Payer: Riverside University Health System MISP |
$7,855.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,975.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
IP
|
$14,959.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
906820281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,991.80 |
| Max. Negotiated Rate |
$13,463.10 |
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,983.60
|
| Rate for Payer: Galaxy Health WC |
$12,715.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,975.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,463.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,977.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,699.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.80
|
| Rate for Payer: Multiplan Commercial |
$11,219.25
|
| Rate for Payer: Networks By Design Commercial |
$9,723.35
|
| Rate for Payer: Prime Health Services Commercial |
$12,715.15
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
OP
|
$14,959.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
909036902
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,112.91 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,141.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,975.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$7,141.35
|
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,967.20
|
| Rate for Payer: Cigna of CA PPO |
$11,069.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$12,715.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,975.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,463.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,219.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,711.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,783.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: InnovAge PACE Commercial |
$10,712.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,977.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,112.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,569.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$11,219.25
|
| Rate for Payer: Networks By Design Commercial |
$9,723.35
|
| Rate for Payer: Prime Health Services Commercial |
$12,715.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,569.83
|
| Rate for Payer: Riverside University Health System MISP |
$7,855.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,975.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC CATH DIALYSIS CRCT W TRNS BLLN
|
Facility
|
IP
|
$14,959.00
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
909036902
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,991.80 |
| Max. Negotiated Rate |
$13,463.10 |
| Rate for Payer: Cash Price |
$6,731.55
|
| Rate for Payer: Central Health Plan Commercial |
$11,967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,983.60
|
| Rate for Payer: Galaxy Health WC |
$12,715.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,975.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,463.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,977.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,699.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.80
|
| Rate for Payer: Multiplan Commercial |
$11,219.25
|
| Rate for Payer: Networks By Design Commercial |
$9,723.35
|
| Rate for Payer: Prime Health Services Commercial |
$12,715.15
|
|
|
HC CATH DIALYSIS TRAY 2LUMEN 13FR
|
Facility
|
IP
|
$2,326.66
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.33 |
| Max. Negotiated Rate |
$2,093.99 |
| Rate for Payer: Blue Shield of California EPN |
$1,242.44
|
| Rate for Payer: Cash Price |
$1,047.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,861.33
|
| Rate for Payer: Cigna of CA HMO |
$1,628.66
|
| Rate for Payer: Cigna of CA PPO |
$1,628.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$930.66
|
| Rate for Payer: Galaxy Health WC |
$1,977.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,093.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,551.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$886.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$465.33
|
| Rate for Payer: Multiplan Commercial |
$1,745.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,977.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.55
|
| Rate for Payer: United Healthcare All Other HMO |
$858.07
|
| Rate for Payer: United Healthcare HMO Rider |
$839.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$767.80
|
|
|
HC CATH DIALYSIS TRAY 2LUMEN 13FR
|
Facility
|
OP
|
$2,326.66
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.33 |
| Max. Negotiated Rate |
$2,093.99 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,977.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,279.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,279.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,062.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,295.95
|
| Rate for Payer: Blue Distinction Transplant |
$1,396.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,745.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,265.70
|
| Rate for Payer: Cash Price |
$1,047.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,861.33
|
| Rate for Payer: Cigna of CA HMO |
$1,628.66
|
| Rate for Payer: Cigna of CA PPO |
$1,628.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,977.66
|
| Rate for Payer: Dignity Health Media |
$1,977.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,977.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$930.66
|
| Rate for Payer: Galaxy Health WC |
$1,977.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,093.99
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,745.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$814.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,551.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$886.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$465.33
|
| Rate for Payer: Multiplan Commercial |
$1,745.00
|
| Rate for Payer: Networks By Design Commercial |
$1,163.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,977.66
|
| Rate for Payer: Riverside University Health System MISP |
$930.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,163.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1,163.33
|
| Rate for Payer: United Healthcare HMO Rider |
$1,163.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,163.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,977.66
|
| Rate for Payer: Vantage Medical Group Senior |
$1,977.66
|
|
|
HC CATH DRAIN EXTERNAL
|
Facility
|
OP
|
$884.86
|
|
| Hospital Charge Code |
901602815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.97 |
| Max. Negotiated Rate |
$796.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$537.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$752.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$486.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$486.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$428.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.78
|
| Rate for Payer: Blue Distinction Transplant |
$530.92
|
| Rate for Payer: Blue Shield of California Commercial |
$556.58
|
| Rate for Payer: Blue Shield of California EPN |
$432.70
|
| Rate for Payer: Cash Price |
$398.19
|
| Rate for Payer: Central Health Plan Commercial |
$707.89
|
| Rate for Payer: Cigna of CA HMO |
$566.31
|
| Rate for Payer: Cigna of CA PPO |
$654.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$752.13
|
| Rate for Payer: Dignity Health Media |
$752.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$353.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$353.94
|
| Rate for Payer: Galaxy Health WC |
$752.13
|
| Rate for Payer: Global Benefits Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$796.37
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$663.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$309.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$590.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$337.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.97
|
| Rate for Payer: Multiplan Commercial |
$663.64
|
| Rate for Payer: Networks By Design Commercial |
$575.16
|
| Rate for Payer: Prime Health Services Commercial |
$752.13
|
| Rate for Payer: Riverside University Health System MISP |
$353.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$530.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$530.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$442.43
|
| Rate for Payer: United Healthcare All Other HMO |
$442.43
|
| Rate for Payer: United Healthcare HMO Rider |
$442.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$442.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.13
|
| Rate for Payer: Vantage Medical Group Senior |
$752.13
|
|
