|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
OP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.10
|
| Rate for Payer: Blue Distinction Transplant |
$11.27
|
| Rate for Payer: Blue Shield of California Commercial |
$11.81
|
| Rate for Payer: Blue Shield of California EPN |
$9.18
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: Cigna of CA HMO |
$12.02
|
| Rate for Payer: Cigna of CA PPO |
$13.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.96
|
| Rate for Payer: Dignity Health Media |
$15.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
| Rate for Payer: Riverside University Health System MISP |
$7.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.39
|
| Rate for Payer: United Healthcare All Other HMO |
$9.39
|
| Rate for Payer: United Healthcare HMO Rider |
$9.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.96
|
| Rate for Payer: Vantage Medical Group Senior |
$15.96
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
IP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
OP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.10
|
| Rate for Payer: Blue Distinction Transplant |
$11.27
|
| Rate for Payer: Blue Shield of California Commercial |
$11.81
|
| Rate for Payer: Blue Shield of California EPN |
$9.18
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: Cigna of CA HMO |
$12.02
|
| Rate for Payer: Cigna of CA PPO |
$13.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.96
|
| Rate for Payer: Dignity Health Media |
$15.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
| Rate for Payer: Riverside University Health System MISP |
$7.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.39
|
| Rate for Payer: United Healthcare All Other HMO |
$9.39
|
| Rate for Payer: United Healthcare HMO Rider |
$9.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.96
|
| Rate for Payer: Vantage Medical Group Senior |
$15.96
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
IP
|
$18.78
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Cash Price |
$8.45
|
| Rate for Payer: Central Health Plan Commercial |
$15.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.51
|
| Rate for Payer: Galaxy Health WC |
$15.96
|
| Rate for Payer: Global Benefits Group Commercial |
$11.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.76
|
| Rate for Payer: Multiplan Commercial |
$14.08
|
| Rate for Payer: Networks By Design Commercial |
$12.21
|
| Rate for Payer: Prime Health Services Commercial |
$15.96
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$4,725.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,887.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,397.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,924.25
|
| Rate for Payer: Blue Distinction Transplant |
$3,150.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,937.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,200.00
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Dignity Health Media |
$4,462.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,462.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,725.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,937.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,837.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,501.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,000.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,050.00
|
| Rate for Payer: Multiplan Commercial |
$3,937.50
|
| Rate for Payer: Networks By Design Commercial |
$2,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: Riverside University Health System MISP |
$2,100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,625.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,625.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,625.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,625.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,462.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,462.50
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$4,725.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,803.50
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,200.00
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,725.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,501.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,000.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,050.00
|
| Rate for Payer: Multiplan Commercial |
$3,937.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,982.40
|
| Rate for Payer: United Healthcare All Other HMO |
$1,936.20
|
| Rate for Payer: United Healthcare HMO Rider |
$1,894.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,732.50
|
|
|
HC CATH KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$782.46 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: 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: Dignity Health Media |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$652.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$304.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| 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 System 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 KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
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: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| 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
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.29
|
| Rate for Payer: United Healthcare All Other HMO |
$320.63
|
| Rate for Payer: United Healthcare HMO Rider |
$313.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$286.90
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
OP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$420.62 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$397.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$257.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$213.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.32
|
| Rate for Payer: Blue Distinction Transplant |
$280.42
|
| Rate for Payer: Blue Shield of California Commercial |
$350.52
|
| Rate for Payer: Blue Shield of California EPN |
$254.24
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Central Health Plan Commercial |
$373.89
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$397.26
|
| Rate for Payer: Dignity Health Media |
$397.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$397.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$420.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$350.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$163.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$311.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.47
|
| Rate for Payer: Multiplan Commercial |
$350.52
|
| Rate for Payer: Networks By Design Commercial |
$233.68
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: Riverside University Health System MISP |
$186.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$280.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.68
|
| Rate for Payer: United Healthcare All Other HMO |
$233.68
|
| Rate for Payer: United Healthcare HMO Rider |
$233.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$233.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$397.26
|
| Rate for Payer: Vantage Medical Group Senior |
$397.26
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
IP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$420.62 |
| Rate for Payer: Blue Shield of California EPN |
$249.57
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Central Health Plan Commercial |
$373.89
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$420.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$311.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.47
|
| Rate for Payer: Multiplan Commercial |
$350.52
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$176.48
|
| Rate for Payer: United Healthcare All Other HMO |
$172.36
|
| Rate for Payer: United Healthcare HMO Rider |
$168.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$154.23
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
IP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$413.58 |
| Rate for Payer: Blue Shield of California EPN |
$245.39
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Central Health Plan Commercial |
$367.62
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.91
|
| Rate for Payer: Multiplan Commercial |
$344.65
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$173.52
|
| Rate for Payer: United Healthcare All Other HMO |
$169.47
|
| Rate for Payer: United Healthcare HMO Rider |
$165.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$151.64
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
OP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$413.58 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$209.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.96
|
| Rate for Payer: Blue Distinction Transplant |
$275.72
|
| Rate for Payer: Blue Shield of California Commercial |
$344.65
|
| Rate for Payer: Blue Shield of California EPN |
$249.98
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Central Health Plan Commercial |
$367.62
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.60
|
| Rate for Payer: Dignity Health Media |
$390.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.58
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$344.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$160.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.91
|
| Rate for Payer: Multiplan Commercial |
$344.65
|
| Rate for Payer: Networks By Design Commercial |
$229.76
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: Riverside University Health System MISP |
$183.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.76
|
| Rate for Payer: United Healthcare All Other HMO |
$229.76
|
| Rate for Payer: United Healthcare HMO Rider |
$229.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.60
|
| Rate for Payer: Vantage Medical Group Senior |
$390.60
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
IP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$39.34 |
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Central Health Plan Commercial |
$34.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$32.78
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
OP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$39.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.82
|
| Rate for Payer: Blue Distinction Transplant |
$26.23
|
| Rate for Payer: Blue Shield of California Commercial |
$27.49
|
| Rate for Payer: Blue Shield of California EPN |
$21.37
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Central Health Plan Commercial |
$34.97
|
| Rate for Payer: Cigna of CA HMO |
$27.97
|
| Rate for Payer: Cigna of CA PPO |
$32.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.15
|
| Rate for Payer: Dignity Health Media |
$37.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$32.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$32.78
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
| Rate for Payer: Riverside University Health System MISP |
$17.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO |
$21.86
|
| Rate for Payer: United Healthcare HMO Rider |
$21.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.15
|
| Rate for Payer: Vantage Medical Group Senior |
$37.15
|
|
|
HC CATH KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
OP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$865.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.77
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: 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: Dignity Health Media |
$817.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$721.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| 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 System 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 KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
IP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
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: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| 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
|
| Rate for Payer: United Healthcare All Other Commercial |
$363.02
|
| Rate for Payer: United Healthcare All Other HMO |
$354.56
|
| Rate for Payer: United Healthcare HMO Rider |
$346.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.26
|
|
|
HC CATH KIT VASCU-PICC 2.6FR SL
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC CATH KIT VASCU-PICC 2.6FR SL
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$556.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$597.89
|
| Rate for Payer: Blue Distinction Transplant |
$607.20
|
| Rate for Payer: Blue Shield of California Commercial |
$636.55
|
| Rate for Payer: Blue Shield of California EPN |
$494.87
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Media |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$759.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC CATH LNRD 10FR REPAIR SGMNT
|
Facility
|
OP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
Hospital Revenue Code
|
272
|
| 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: Alpha Care Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$528.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$568.00
|
| Rate for Payer: Blue Distinction Transplant |
$576.84
|
| Rate for Payer: Blue Shield of California Commercial |
$604.72
|
| Rate for Payer: Blue Shield of California EPN |
$470.12
|
| 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 |
$615.30
|
| Rate for Payer: Cigna of CA PPO |
$711.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$817.19
|
| Rate for Payer: Dignity Health Media |
$817.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$721.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| 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 |
$624.91
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: Riverside University Health System 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 LNRD 10FR REPAIR SGMNT
|
Facility
|
IP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$865.26 |
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Central Health Plan Commercial |
$769.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| 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 |
$624.91
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
|
|
HC CATH LO FRIC 14FR COUDE
|
Facility
|
OP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.72
|
| Rate for Payer: Blue Distinction Transplant |
$11.90
|
| Rate for Payer: Blue Shield of California Commercial |
$12.48
|
| Rate for Payer: Blue Shield of California EPN |
$9.70
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Central Health Plan Commercial |
$15.87
|
| Rate for Payer: Cigna of CA HMO |
$12.70
|
| Rate for Payer: Cigna of CA PPO |
$14.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.86
|
| Rate for Payer: Dignity Health Media |
$16.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.97
|
| Rate for Payer: Multiplan Commercial |
$14.88
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.92
|
| Rate for Payer: United Healthcare All Other HMO |
$9.92
|
| Rate for Payer: United Healthcare HMO Rider |
$9.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.86
|
| Rate for Payer: Vantage Medical Group Senior |
$16.86
|
|
|
HC CATH LO FRIC 14FR COUDE
|
Facility
|
IP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Central Health Plan Commercial |
$15.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.97
|
| Rate for Payer: Multiplan Commercial |
$14.88
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
|
|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.45
|
| Rate for Payer: Blue Distinction Transplant |
$6.55
|
| Rate for Payer: Blue Shield of California Commercial |
$6.86
|
| Rate for Payer: Blue Shield of California EPN |
$5.33
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Media |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Riverside University Health System MISP |
$4.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Central Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.18
|
| Rate for Payer: Multiplan Commercial |
$8.18
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH LO-FRIC HYDRO 12FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
