|
HC CATH MALE EXT .30MM STANDARD
|
Facility
|
OP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.73
|
| Rate for Payer: Blue Distinction Transplant |
$115.50
|
| Rate for Payer: Blue Shield of California Commercial |
$121.08
|
| Rate for Payer: Blue Shield of California EPN |
$94.13
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: Cigna of CA HMO |
$123.20
|
| Rate for Payer: Cigna of CA PPO |
$142.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.62
|
| Rate for Payer: Dignity Health Media |
$163.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$144.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
| Rate for Payer: Riverside University Health System MISP |
$77.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.25
|
| Rate for Payer: United Healthcare All Other HMO |
$96.25
|
| Rate for Payer: United Healthcare HMO Rider |
$96.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.62
|
| Rate for Payer: Vantage Medical Group Senior |
$163.62
|
|
|
HC CATH MALE EXT .35MM SPORT
|
Facility
|
OP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.73
|
| Rate for Payer: Blue Distinction Transplant |
$115.50
|
| Rate for Payer: Blue Shield of California Commercial |
$121.08
|
| Rate for Payer: Blue Shield of California EPN |
$94.13
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: Cigna of CA HMO |
$123.20
|
| Rate for Payer: Cigna of CA PPO |
$142.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.62
|
| Rate for Payer: Dignity Health Media |
$163.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$144.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
| Rate for Payer: Riverside University Health System MISP |
$77.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$96.25
|
| Rate for Payer: United Healthcare All Other HMO |
$96.25
|
| Rate for Payer: United Healthcare HMO Rider |
$96.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.62
|
| Rate for Payer: Vantage Medical Group Senior |
$163.62
|
|
|
HC CATH MALE EXT .35MM SPORT
|
Facility
|
IP
|
$192.50
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Cash Price |
$86.63
|
| Rate for Payer: Central Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.00
|
| Rate for Payer: Galaxy Health WC |
$163.62
|
| Rate for Payer: Global Benefits Group Commercial |
$115.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.50
|
| Rate for Payer: Multiplan Commercial |
$144.38
|
| Rate for Payer: Networks By Design Commercial |
$125.12
|
| Rate for Payer: Prime Health Services Commercial |
$163.62
|
|
|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
IP
|
$8.77
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$7.89 |
| Rate for Payer: Cash Price |
$3.95
|
| Rate for Payer: Central Health Plan Commercial |
$7.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.51
|
| Rate for Payer: Galaxy Health WC |
$7.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$6.58
|
| Rate for Payer: Networks By Design Commercial |
$5.70
|
| Rate for Payer: Prime Health Services Commercial |
$7.45
|
|
|
HC CATH MALE EXT .35MM STANDARD
|
Facility
|
OP
|
$8.77
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901607608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$7.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.18
|
| Rate for Payer: Blue Distinction Transplant |
$5.26
|
| Rate for Payer: Blue Shield of California Commercial |
$5.52
|
| Rate for Payer: Blue Shield of California EPN |
$4.29
|
| Rate for Payer: Cash Price |
$3.95
|
| Rate for Payer: Cash Price |
$3.95
|
| Rate for Payer: Central Health Plan Commercial |
$7.02
|
| Rate for Payer: Cigna of CA HMO |
$5.61
|
| Rate for Payer: Cigna of CA PPO |
$6.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.45
|
| Rate for Payer: Dignity Health Media |
$7.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.51
|
| Rate for Payer: Galaxy Health WC |
$7.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.89
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$6.58
|
| Rate for Payer: Networks By Design Commercial |
$5.70
|
| Rate for Payer: Prime Health Services Commercial |
$7.45
|
| Rate for Payer: Riverside University Health System MISP |
$3.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7.45
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
OP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.51
|
| Rate for Payer: Blue Distinction Transplant |
$4.58
|
| Rate for Payer: Blue Shield of California Commercial |
$4.80
|
| Rate for Payer: Blue Shield of California EPN |
$3.73
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: Cigna of CA HMO |
$4.88
|
| Rate for Payer: Cigna of CA PPO |
$5.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.49
|
| Rate for Payer: Dignity Health Media |
$6.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
| Rate for Payer: Riverside University Health System MISP |
$3.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.82
|
| Rate for Payer: United Healthcare All Other HMO |
$3.82
|
| Rate for Payer: United Healthcare HMO Rider |
$3.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.49
|
| Rate for Payer: Vantage Medical Group Senior |
$6.49
|
|
|
HC CATH MALE EXTRNL SM 23MM CLR
|
Facility
|
IP
|
$7.63
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$144.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.06
|
| Rate for Payer: Blue Distinction Transplant |
$178.80
|
| Rate for Payer: Blue Shield of California Commercial |
$187.44
|
| Rate for Payer: Blue Shield of California EPN |
$145.72
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Central Health Plan Commercial |
$238.40
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Media |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$268.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$223.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$104.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.60
|
| Rate for Payer: Multiplan Commercial |
$223.50
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Riverside University Health System MISP |
$119.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH MED NIH
|
Facility
|
IP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC CATH MED NIH
|
Facility
|
OP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$322.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$292.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$257.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$313.71
|
| Rate for Payer: Blue Distinction Transplant |
$318.60
|
| Rate for Payer: Blue Shield of California Commercial |
$334.00
|
| Rate for Payer: Blue Shield of California EPN |
$259.66
|
| Rate for Payer: Cash Price |
$238.95
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Media |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$398.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$185.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Riverside University Health System MISP |
$212.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$265.50
|
| Rate for Payer: United Healthcare All Other HMO |
$265.50
|
| Rate for Payer: United Healthcare HMO Rider |
$265.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC CATH MERIT MOD V
|
Facility
|
IP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$92.34 |
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
|
|
HC CATH MERIT MOD V
|
Facility
|
OP
|
$102.60
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.62
|
| Rate for Payer: Blue Distinction Transplant |
$61.56
|
| Rate for Payer: Blue Shield of California Commercial |
$64.54
|
| Rate for Payer: Blue Shield of California EPN |
$50.17
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Cash Price |
$46.17
|
| Rate for Payer: Central Health Plan Commercial |
$82.08
|
| Rate for Payer: Cigna of CA HMO |
$65.66
|
| Rate for Payer: Cigna of CA PPO |
$75.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.21
|
| Rate for Payer: Dignity Health Media |
$87.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.04
|
| Rate for Payer: Galaxy Health WC |
$87.21
|
| Rate for Payer: Global Benefits Group Commercial |
$61.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$76.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.52
|
| Rate for Payer: Multiplan Commercial |
$76.95
|
| Rate for Payer: Networks By Design Commercial |
$66.69
|
| Rate for Payer: Prime Health Services Commercial |
$87.21
|
| Rate for Payer: Riverside University Health System MISP |
$41.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.30
|
| Rate for Payer: United Healthcare All Other HMO |
$51.30
|
| Rate for Payer: United Healthcare HMO Rider |
$51.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.21
|
| Rate for Payer: Vantage Medical Group Senior |
$87.21
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Blue Shield of California EPN |
$294.23
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$208.06
|
| Rate for Payer: United Healthcare All Other HMO |
$203.21
|
| Rate for Payer: United Healthcare HMO Rider |
$198.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$181.83
|
|
|
HC CATH MIDLINE 3FR 20CM SL CDC
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$303.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$251.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$306.91
|
| Rate for Payer: Blue Distinction Transplant |
$330.60
|
| Rate for Payer: Blue Shield of California Commercial |
$413.25
|
| Rate for Payer: Blue Shield of California EPN |
$299.74
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$385.70
|
| Rate for Payer: Cigna of CA PPO |
$385.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Media |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$413.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$275.50
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Riverside University Health System MISP |
$220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.50
|
| Rate for Payer: United Healthcare All Other HMO |
$275.50
|
| Rate for Payer: United Healthcare HMO Rider |
$275.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
IP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.92 |
| Rate for Payer: Blue Shield of California EPN |
$568.36
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$401.90
|
| Rate for Payer: United Healthcare All Other HMO |
$392.53
|
| Rate for Payer: United Healthcare HMO Rider |
$384.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$351.24
|
|
|
HC CATH MIDLINE 4FR 20CM SL CDC KIT
|
Facility
|
OP
|
$1,064.35
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.87 |
| Max. Negotiated Rate |
$957.92 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$904.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$585.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$585.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$485.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$592.84
|
| Rate for Payer: Blue Distinction Transplant |
$638.61
|
| Rate for Payer: Blue Shield of California Commercial |
$798.26
|
| Rate for Payer: Blue Shield of California EPN |
$579.01
|
| Rate for Payer: Cash Price |
$478.96
|
| Rate for Payer: Central Health Plan Commercial |
$851.48
|
| Rate for Payer: Cigna of CA HMO |
$745.04
|
| Rate for Payer: Cigna of CA PPO |
$745.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$904.70
|
| Rate for Payer: Dignity Health Media |
$904.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$904.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$425.74
|
| Rate for Payer: Galaxy Health WC |
$904.70
|
| Rate for Payer: Global Benefits Group Commercial |
$638.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$957.92
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$798.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$372.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.87
|
| Rate for Payer: Multiplan Commercial |
$798.26
|
| Rate for Payer: Networks By Design Commercial |
$532.18
|
| Rate for Payer: Prime Health Services Commercial |
$904.70
|
| Rate for Payer: Riverside University Health System MISP |
$425.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$638.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$638.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$532.18
|
| Rate for Payer: United Healthcare All Other HMO |
$532.18
|
| Rate for Payer: United Healthcare HMO Rider |
$532.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$532.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$904.70
|
| Rate for Payer: Vantage Medical Group Senior |
$904.70
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
OP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$618.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$399.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$399.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$332.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$405.01
|
| Rate for Payer: Blue Distinction Transplant |
$436.27
|
| Rate for Payer: Blue Shield of California Commercial |
$545.34
|
| Rate for Payer: Blue Shield of California EPN |
$395.55
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$618.05
|
| Rate for Payer: Dignity Health Media |
$618.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$618.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$545.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Networks By Design Commercial |
$363.56
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: Riverside University Health System MISP |
$290.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$436.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$436.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$363.56
|
| Rate for Payer: United Healthcare All Other HMO |
$363.56
|
| Rate for Payer: United Healthcare HMO Rider |
$363.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$363.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$618.05
|
| Rate for Payer: Vantage Medical Group Senior |
$618.05
|
|
|
HC CATH MIDLINE 4FR SL 15CM
|
Facility
|
IP
|
$727.12
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$654.41 |
| Rate for Payer: Blue Shield of California EPN |
$388.28
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Central Health Plan Commercial |
$581.70
|
| Rate for Payer: Cigna of CA HMO |
$508.98
|
| Rate for Payer: Cigna of CA PPO |
$508.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$290.85
|
| Rate for Payer: Galaxy Health WC |
$618.05
|
| Rate for Payer: Global Benefits Group Commercial |
$436.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$654.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$484.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$277.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.42
|
| Rate for Payer: Multiplan Commercial |
$545.34
|
| Rate for Payer: Prime Health Services Commercial |
$618.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$274.56
|
| Rate for Payer: United Healthcare All Other HMO |
$268.16
|
| Rate for Payer: United Healthcare HMO Rider |
$262.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$239.95
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
OP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$425.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$353.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$430.81
|
| Rate for Payer: Blue Distinction Transplant |
$464.06
|
| Rate for Payer: Blue Shield of California Commercial |
$580.08
|
| Rate for Payer: Blue Shield of California EPN |
$420.75
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.42
|
| Rate for Payer: Dignity Health Media |
$657.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$580.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$270.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Networks By Design Commercial |
$386.72
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: Riverside University Health System MISP |
$309.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$386.72
|
| Rate for Payer: United Healthcare All Other HMO |
$386.72
|
| Rate for Payer: United Healthcare HMO Rider |
$386.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$386.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.42
|
| Rate for Payer: Vantage Medical Group Senior |
$657.42
|
|
|
HC CATH MIDLINE 5FR DL 15CM
|
Facility
|
IP
|
$773.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.69 |
| Max. Negotiated Rate |
$696.10 |
| Rate for Payer: Blue Shield of California EPN |
$413.02
|
| Rate for Payer: Cash Price |
$348.05
|
| Rate for Payer: Central Health Plan Commercial |
$618.75
|
| Rate for Payer: Cigna of CA HMO |
$541.41
|
| Rate for Payer: Cigna of CA PPO |
$541.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$309.38
|
| Rate for Payer: Galaxy Health WC |
$657.42
|
| Rate for Payer: Global Benefits Group Commercial |
$464.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.69
|
| Rate for Payer: Multiplan Commercial |
$580.08
|
| Rate for Payer: Prime Health Services Commercial |
$657.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$292.05
|
| Rate for Payer: United Healthcare All Other HMO |
$285.24
|
| Rate for Payer: United Healthcare HMO Rider |
$279.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$255.24
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
IP
|
$731.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.28 |
| Max. Negotiated Rate |
$658.26 |
| Rate for Payer: Blue Shield of California EPN |
$390.57
|
| Rate for Payer: Cash Price |
$329.13
|
| Rate for Payer: Central Health Plan Commercial |
$585.12
|
| Rate for Payer: Cigna of CA HMO |
$511.98
|
| Rate for Payer: Cigna of CA PPO |
$511.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$292.56
|
| Rate for Payer: Galaxy Health WC |
$621.69
|
| Rate for Payer: Global Benefits Group Commercial |
$438.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$658.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$487.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Multiplan Commercial |
$548.55
|
| Rate for Payer: Prime Health Services Commercial |
$621.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$276.18
|
| Rate for Payer: United Healthcare All Other HMO |
$269.74
|
| Rate for Payer: United Healthcare HMO Rider |
$263.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$241.36
|
|
|
HC CATH MIDLINE KIT 4.5FRX15CM
|
Facility
|
OP
|
$731.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.28 |
| Max. Negotiated Rate |
$658.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$621.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$402.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$402.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$333.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$407.39
|
| Rate for Payer: Blue Distinction Transplant |
$438.84
|
| Rate for Payer: Blue Shield of California Commercial |
$548.55
|
| Rate for Payer: Blue Shield of California EPN |
$397.88
|
| Rate for Payer: Cash Price |
$329.13
|
| Rate for Payer: Central Health Plan Commercial |
$585.12
|
| Rate for Payer: Cigna of CA HMO |
$511.98
|
| Rate for Payer: Cigna of CA PPO |
$511.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$621.69
|
| Rate for Payer: Dignity Health Media |
$621.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$621.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$292.56
|
| Rate for Payer: Galaxy Health WC |
$621.69
|
| Rate for Payer: Global Benefits Group Commercial |
$438.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$658.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$548.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$255.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$487.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.28
|
| Rate for Payer: Multiplan Commercial |
$548.55
|
| Rate for Payer: Networks By Design Commercial |
$365.70
|
| Rate for Payer: Prime Health Services Commercial |
$621.69
|
| Rate for Payer: Riverside University Health System MISP |
$292.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$438.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$438.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$365.70
|
| Rate for Payer: United Healthcare All Other HMO |
$365.70
|
| Rate for Payer: United Healthcare HMO Rider |
$365.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$365.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$621.69
|
| Rate for Payer: Vantage Medical Group Senior |
$621.69
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
IP
|
$777.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$155.48 |
| Max. Negotiated Rate |
$699.66 |
| Rate for Payer: Blue Shield of California EPN |
$415.13
|
| Rate for Payer: Cash Price |
$349.83
|
| Rate for Payer: Central Health Plan Commercial |
$621.92
|
| Rate for Payer: Cigna of CA HMO |
$544.18
|
| Rate for Payer: Cigna of CA PPO |
$544.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$310.96
|
| Rate for Payer: Galaxy Health WC |
$660.79
|
| Rate for Payer: Global Benefits Group Commercial |
$466.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$699.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$518.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$296.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.48
|
| Rate for Payer: Multiplan Commercial |
$583.05
|
| Rate for Payer: Prime Health Services Commercial |
$660.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$293.55
|
| Rate for Payer: United Healthcare All Other HMO |
$286.71
|
| Rate for Payer: United Healthcare HMO Rider |
$280.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.54
|
|
|
HC CATH MIDLINE KIT 5.5FRX15CM
|
Facility
|
OP
|
$777.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$155.48 |
| Max. Negotiated Rate |
$699.66 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$660.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$427.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$427.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$354.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$433.01
|
| Rate for Payer: Blue Distinction Transplant |
$466.44
|
| Rate for Payer: Blue Shield of California Commercial |
$583.05
|
| Rate for Payer: Blue Shield of California EPN |
$422.91
|
| Rate for Payer: Cash Price |
$349.83
|
| Rate for Payer: Central Health Plan Commercial |
$621.92
|
| Rate for Payer: Cigna of CA HMO |
$544.18
|
| Rate for Payer: Cigna of CA PPO |
$544.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$660.79
|
| Rate for Payer: Dignity Health Media |
$660.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$660.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$310.96
|
| Rate for Payer: Galaxy Health WC |
$660.79
|
| Rate for Payer: Global Benefits Group Commercial |
$466.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$699.66
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$583.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$272.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$518.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$296.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.48
|
| Rate for Payer: Multiplan Commercial |
$583.05
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$660.79
|
| Rate for Payer: Riverside University Health System MISP |
$310.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$466.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$466.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$388.70
|
| Rate for Payer: United Healthcare All Other HMO |
$388.70
|
| Rate for Payer: United Healthcare HMO Rider |
$388.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$388.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$660.79
|
| Rate for Payer: Vantage Medical Group Senior |
$660.79
|
|
