|
HC CATH GUIDT SWIFT NINJA
|
Facility
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Blue Shield of California EPN |
$2,603.25
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
|
|
HC CATH GUIDT SWIFT NINJA
|
Facility
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$396.30 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,681.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,225.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,715.38
|
| Rate for Payer: BCBS Transplant Transplant |
$2,925.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,656.25
|
| Rate for Payer: Blue Shield of California EPN |
$2,652.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,656.25
|
| Rate for Payer: IEHP medi-cal |
$1,706.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Riverside University Health MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
IP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$830.15 |
| Rate for Payer: Blue Shield of California EPN |
$492.56
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Central Health Plan Commercial |
$737.91
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$830.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.48
|
| Rate for Payer: Multiplan Commercial |
$691.79
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
OP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$784.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$507.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$507.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.77
|
| Rate for Payer: BCBS Transplant Transplant |
$553.43
|
| Rate for Payer: Blue Shield of California Commercial |
$691.79
|
| Rate for Payer: Blue Shield of California EPN |
$501.78
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Central Health Plan Commercial |
$737.91
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$830.15
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$691.79
|
| Rate for Payer: IEHP medi-cal |
$322.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.48
|
| Rate for Payer: Multiplan Commercial |
$691.79
|
| Rate for Payer: Networks By Design Commercial |
$461.20
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
| Rate for Payer: Riverside University Health MISP |
$368.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$553.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$553.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$461.20
|
| Rate for Payer: United Healthcare All Other HMO |
$461.20
|
| Rate for Payer: United Healthcare HMO Rider |
$461.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$461.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$784.03
|
| Rate for Payer: Vantage Medical Group Senior |
$784.03
|
|
|
HC CATH HEMO-CATH 8FR 12CM PEDS
|
Facility
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603577
|
|
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: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH HEMO-CATH 8FR 12CM PEDS
|
Facility
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603577
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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: 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 Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| 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 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 HEMODIALYSIS DBL LUMEN
|
Facility
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$303.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.97
|
| Rate for Payer: BCBS Transplant Transplant |
$330.67
|
| Rate for Payer: Blue Shield of California Commercial |
$413.34
|
| Rate for Payer: Blue Shield of California EPN |
$299.81
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$413.34
|
| Rate for Payer: IEHP medi-cal |
$192.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.56
|
| Rate for Payer: United Healthcare All Other HMO |
$275.56
|
| Rate for Payer: United Healthcare HMO Rider |
$275.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMODIALYSIS DBL LUMEN
|
Facility
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Blue Shield of California EPN |
$294.30
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
|
|
HC CATH HEMODIALYSIS LONG TERM
|
Facility
OP
|
$2,148.20
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$429.64 |
| Max. Negotiated Rate |
$2,565.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,565.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,825.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,181.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,181.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$980.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,196.55
|
| Rate for Payer: BCBS Transplant Transplant |
$1,288.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,611.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,168.62
|
| Rate for Payer: Cash Price |
$966.69
|
| Rate for Payer: Cash Price |
$966.69
|
| Rate for Payer: Central Health Plan Commercial |
$1,718.56
|
| Rate for Payer: Cigna of CA HMO |
$1,503.74
|
| Rate for Payer: Cigna of CA PPO |
$1,503.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,825.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$859.28
|
| Rate for Payer: Galaxy Health WC |
$1,825.97
|
| Rate for Payer: Global Benefits Group Commercial |
$1,288.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,933.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,611.15
|
| Rate for Payer: IEHP medi-cal |
$751.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,432.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.64
|
| Rate for Payer: Multiplan Commercial |
$1,611.15
|
| Rate for Payer: Networks By Design Commercial |
$1,074.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,825.97
|
| Rate for Payer: Riverside University Health MISP |
$859.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,288.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,288.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,074.10
|
| Rate for Payer: United Healthcare All Other HMO |
$1,074.10
|
| Rate for Payer: United Healthcare HMO Rider |
$1,074.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,074.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,825.97
|
| Rate for Payer: Vantage Medical Group Senior |
$1,825.97
|
|
|
HC CATH HEMODIALYSIS LONG TERM
|
Facility
IP
|
$2,148.20
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$429.64 |
| Max. Negotiated Rate |
$1,933.38 |
| Rate for Payer: Blue Shield of California EPN |
$1,147.14
|
| Rate for Payer: Cash Price |
$966.69
|
| Rate for Payer: Central Health Plan Commercial |
$1,718.56
|
| Rate for Payer: Cigna of CA HMO |
$1,503.74
|
| Rate for Payer: Cigna of CA PPO |
$1,503.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$859.28
|
| Rate for Payer: Galaxy Health WC |
$1,825.97
|
| Rate for Payer: Global Benefits Group Commercial |
$1,288.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,933.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,432.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.64
|
| Rate for Payer: Multiplan Commercial |
$1,611.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,825.97
|
|
|
HC CATH HEMODIALYSIS SHORT-TERM
|
Facility
OP
|
$376.24
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
909081449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.25 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$319.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$206.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$206.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$171.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$209.57
|
| Rate for Payer: BCBS Transplant Transplant |
$225.74
|
| Rate for Payer: Blue Shield of California Commercial |
$282.18
|
| Rate for Payer: Blue Shield of California EPN |
$204.67
|
| Rate for Payer: Cash Price |
$169.31
|
| Rate for Payer: Cash Price |
$169.31
|
| Rate for Payer: Central Health Plan Commercial |
$300.99
|
| Rate for Payer: Cigna of CA HMO |
$263.37
|
| Rate for Payer: Cigna of CA PPO |
$263.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$319.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$150.50
|
| Rate for Payer: Galaxy Health WC |
$319.80
|
| Rate for Payer: Global Benefits Group Commercial |
$225.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$338.62
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$282.18
|
| Rate for Payer: IEHP medi-cal |
$131.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$250.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.25
|
| Rate for Payer: Multiplan Commercial |
$282.18
|
| Rate for Payer: Networks By Design Commercial |
$188.12
|
| Rate for Payer: Prime Health Services Commercial |
$319.80
|
| Rate for Payer: Riverside University Health MISP |
$150.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$225.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.12
|
| Rate for Payer: United Healthcare All Other HMO |
$188.12
|
| Rate for Payer: United Healthcare HMO Rider |
$188.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$319.80
|
| Rate for Payer: Vantage Medical Group Senior |
$319.80
|
|
|
HC CATH HEMODIALYSIS SHORT-TERM
|
Facility
IP
|
$376.24
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
909081449
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.25 |
| Max. Negotiated Rate |
$338.62 |
| Rate for Payer: Blue Shield of California EPN |
$200.91
|
| Rate for Payer: Cash Price |
$169.31
|
| Rate for Payer: Central Health Plan Commercial |
$300.99
|
| Rate for Payer: Cigna of CA HMO |
$263.37
|
| Rate for Payer: Cigna of CA PPO |
$263.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$150.50
|
| Rate for Payer: Galaxy Health WC |
$319.80
|
| Rate for Payer: Global Benefits Group Commercial |
$225.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$338.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$250.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.25
|
| Rate for Payer: Multiplan Commercial |
$282.18
|
| Rate for Payer: Prime Health Services Commercial |
$319.80
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Blue Shield of California EPN |
$294.30
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 16CM
|
Facility
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$303.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.97
|
| Rate for Payer: BCBS Transplant Transplant |
$330.67
|
| Rate for Payer: Blue Shield of California Commercial |
$413.34
|
| Rate for Payer: Blue Shield of California EPN |
$299.81
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$413.34
|
| Rate for Payer: IEHP medi-cal |
$192.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.56
|
| Rate for Payer: United Healthcare All Other HMO |
$275.56
|
| Rate for Payer: United Healthcare HMO Rider |
$275.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
IP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$496.01 |
| Rate for Payer: Blue Shield of California EPN |
$294.30
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
|
|
HC CATH HEMO MAHURKAR 12FR 19.5CM
|
Facility
OP
|
$551.12
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.22 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$468.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$303.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$303.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.97
|
| Rate for Payer: BCBS Transplant Transplant |
$330.67
|
| Rate for Payer: Blue Shield of California Commercial |
$413.34
|
| Rate for Payer: Blue Shield of California EPN |
$299.81
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Central Health Plan Commercial |
$440.90
|
| Rate for Payer: Cigna of CA HMO |
$385.78
|
| Rate for Payer: Cigna of CA PPO |
$385.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.45
|
| Rate for Payer: Galaxy Health WC |
$468.45
|
| Rate for Payer: Global Benefits Group Commercial |
$330.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$496.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$413.34
|
| Rate for Payer: IEHP medi-cal |
$192.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.22
|
| Rate for Payer: Multiplan Commercial |
$413.34
|
| Rate for Payer: Networks By Design Commercial |
$275.56
|
| Rate for Payer: Prime Health Services Commercial |
$468.45
|
| Rate for Payer: Riverside University Health MISP |
$220.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.56
|
| Rate for Payer: United Healthcare All Other HMO |
$275.56
|
| Rate for Payer: United Healthcare HMO Rider |
$275.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.45
|
| Rate for Payer: Vantage Medical Group Senior |
$468.45
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Blue Shield of California EPN |
$464.26
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
|
HC CATH HICKMAN 6.6FR EXT SEGMNT
|
Facility
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$396.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$484.26
|
| Rate for Payer: BCBS Transplant Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$652.05
|
| Rate for Payer: Blue Shield of California EPN |
$472.95
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$652.05
|
| Rate for Payer: IEHP medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Riverside University Health MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH HICKMAN 7FR
|
Facility
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$420.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.64
|
| Rate for Payer: BCBS Transplant Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$546.85
|
| Rate for Payer: Blue Shield of California EPN |
$425.14
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$556.42
|
| Rate for Payer: Cigna of CA PPO |
$643.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$652.05
|
| Rate for Payer: IEHP medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: Riverside University Health MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH HICKMAN 7FR
|
Facility
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
OP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$528.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$528.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$438.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$535.50
|
| Rate for Payer: BCBS Transplant Transplant |
$576.84
|
| Rate for Payer: Blue Shield of California Commercial |
$721.05
|
| Rate for Payer: Blue Shield of California EPN |
$523.00
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Central Health Plan Commercial |
$769.12
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$817.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$865.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$721.05
|
| Rate for Payer: IEHP medi-cal |
$336.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.28
|
| Rate for Payer: Multiplan Commercial |
$721.05
|
| Rate for Payer: Networks By Design Commercial |
$480.70
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: Riverside University Health MISP |
$384.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$480.70
|
| Rate for Payer: United Healthcare All Other HMO |
$480.70
|
| Rate for Payer: United Healthcare HMO Rider |
$480.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$480.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$817.19
|
| Rate for Payer: Vantage Medical Group Senior |
$817.19
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
IP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$865.26 |
| Rate for Payer: Blue Shield of California EPN |
$513.39
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Central Health Plan Commercial |
$769.12
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$865.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.28
|
| Rate for Payer: Multiplan Commercial |
$721.05
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Blue Shield of California EPN |
$464.26
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$478.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$396.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$484.26
|
| Rate for Payer: BCBS Transplant Transplant |
$521.64
|
| Rate for Payer: Blue Shield of California Commercial |
$652.05
|
| Rate for Payer: Blue Shield of California EPN |
$472.95
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Central Health Plan Commercial |
$695.52
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$782.46
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$652.05
|
| Rate for Payer: IEHP medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.88
|
| Rate for Payer: Multiplan Commercial |
$652.05
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Riverside University Health MISP |
$347.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
IP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$19.33 |
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Central Health Plan Commercial |
$17.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.30
|
| Rate for Payer: Multiplan Commercial |
$16.11
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
