|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH MILLAR MICRO TIP SPC-320
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
906812398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,265.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,358.84
|
| Rate for Payer: Blue Distinction Transplant |
$1,380.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,446.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,124.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Media |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,725.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Riverside University Health System MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
OP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$1,048.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$707.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$990.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$640.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$640.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$564.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$688.22
|
| Rate for Payer: Blue Distinction Transplant |
$698.94
|
| Rate for Payer: Blue Shield of California Commercial |
$732.72
|
| Rate for Payer: Blue Shield of California EPN |
$569.64
|
| Rate for Payer: Cash Price |
$524.21
|
| Rate for Payer: Central Health Plan Commercial |
$931.92
|
| Rate for Payer: Cigna of CA HMO |
$745.54
|
| Rate for Payer: Cigna of CA PPO |
$862.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$990.16
|
| Rate for Payer: Dignity Health Media |
$990.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$990.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$465.96
|
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.41
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$873.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$407.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.98
|
| Rate for Payer: Multiplan Commercial |
$873.68
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
| Rate for Payer: Riverside University Health System MISP |
$465.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$698.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$698.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$582.45
|
| Rate for Payer: United Healthcare All Other HMO |
$582.45
|
| Rate for Payer: United Healthcare HMO Rider |
$582.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$582.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$990.16
|
| Rate for Payer: Vantage Medical Group Senior |
$990.16
|
|
|
HC CATH PACING ELECTRODE 5FR
|
Facility
|
IP
|
$1,164.90
|
|
| Hospital Charge Code |
901607263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$232.98 |
| Max. Negotiated Rate |
$1,048.41 |
| Rate for Payer: Cash Price |
$524.21
|
| Rate for Payer: Central Health Plan Commercial |
$931.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.96
|
| Rate for Payer: Galaxy Health WC |
$990.16
|
| Rate for Payer: Global Benefits Group Commercial |
$698.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,048.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$776.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.98
|
| Rate for Payer: Multiplan Commercial |
$873.68
|
| Rate for Payer: Networks By Design Commercial |
$757.18
|
| Rate for Payer: Prime Health Services Commercial |
$990.16
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
OP
|
$42.72
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.24
|
| Rate for Payer: Blue Distinction Transplant |
$25.63
|
| Rate for Payer: Blue Shield of California Commercial |
$26.87
|
| Rate for Payer: Blue Shield of California EPN |
$20.89
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Central Health Plan Commercial |
$34.18
|
| Rate for Payer: Cigna of CA HMO |
$27.34
|
| Rate for Payer: Cigna of CA PPO |
$31.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.31
|
| Rate for Payer: Dignity Health Media |
$36.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.45
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$32.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Multiplan Commercial |
$32.04
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
| Rate for Payer: Riverside University Health System MISP |
$17.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.36
|
| Rate for Payer: United Healthcare All Other HMO |
$21.36
|
| Rate for Payer: United Healthcare HMO Rider |
$21.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Vantage Medical Group Senior |
$36.31
|
|
|
HC CATH PEDS 10FR 3ML W 5ML SW
|
Facility
|
IP
|
$42.72
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$38.45 |
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Central Health Plan Commercial |
$34.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Multiplan Commercial |
$32.04
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
OP
|
$46.25
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.32
|
| Rate for Payer: Blue Distinction Transplant |
$27.75
|
| Rate for Payer: Blue Shield of California Commercial |
$29.09
|
| Rate for Payer: Blue Shield of California EPN |
$22.62
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Central Health Plan Commercial |
$37.00
|
| Rate for Payer: Cigna of CA HMO |
$29.60
|
| Rate for Payer: Cigna of CA PPO |
$34.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.31
|
| Rate for Payer: Dignity Health Media |
$39.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.50
|
| Rate for Payer: Galaxy Health WC |
$39.31
|
| Rate for Payer: Global Benefits Group Commercial |
$27.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$34.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: Multiplan Commercial |
$34.69
|
| Rate for Payer: Networks By Design Commercial |
$30.06
|
| Rate for Payer: Prime Health Services Commercial |
$39.31
|
| Rate for Payer: Riverside University Health System MISP |
$18.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.12
|
| Rate for Payer: United Healthcare All Other HMO |
$23.12
|
| Rate for Payer: United Healthcare HMO Rider |
$23.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.31
|
| Rate for Payer: Vantage Medical Group Senior |
$39.31
|
|
|
HC CATH PEDS 8FR 3ML W 5ML SW
|
Facility
|
IP
|
$46.25
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Central Health Plan Commercial |
$37.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.50
|
| Rate for Payer: Galaxy Health WC |
$39.31
|
| Rate for Payer: Global Benefits Group Commercial |
$27.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: Multiplan Commercial |
$34.69
|
| Rate for Payer: Networks By Design Commercial |
$30.06
|
| Rate for Payer: Prime Health Services Commercial |
$39.31
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
OP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$15,440.40 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,435.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,435.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,833.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,555.89
|
| Rate for Payer: Blue Distinction Transplant |
$10,293.60
|
| Rate for Payer: Blue Shield of California Commercial |
$12,867.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,332.86
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Central Health Plan Commercial |
$13,724.80
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,582.60
|
| Rate for Payer: Dignity Health Media |
$14,582.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,582.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,440.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,867.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,004.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,536.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.20
|
| Rate for Payer: Multiplan Commercial |
$12,867.00
|
| Rate for Payer: Networks By Design Commercial |
$8,578.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: Riverside University Health System MISP |
$6,862.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,293.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,293.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,578.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,578.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,578.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,578.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,582.60
|
| Rate for Payer: Vantage Medical Group Senior |
$14,582.60
|
|
|
HC CATH PENUMBRA 3D STNT RTRVR
|
Facility
|
IP
|
$17,156.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909011757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,431.20 |
| Max. Negotiated Rate |
$15,440.40 |
| Rate for Payer: Blue Shield of California EPN |
$9,161.30
|
| Rate for Payer: Cash Price |
$7,720.20
|
| Rate for Payer: Central Health Plan Commercial |
$13,724.80
|
| Rate for Payer: Cigna of CA HMO |
$12,009.20
|
| Rate for Payer: Cigna of CA PPO |
$12,009.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,862.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,862.40
|
| Rate for Payer: Galaxy Health WC |
$14,582.60
|
| Rate for Payer: Global Benefits Group Commercial |
$10,293.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,440.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,443.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,536.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,431.20
|
| Rate for Payer: Multiplan Commercial |
$12,867.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,582.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,478.11
|
| Rate for Payer: United Healthcare All Other HMO |
$6,327.13
|
| Rate for Payer: United Healthcare HMO Rider |
$6,189.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,661.48
|
|
|
HC CATH PENUMBRA SELECT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH PENUMBRA SELECT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PERITONEAL DIALYSIS PEDS
|
Facility
|
OP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$89.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.82
|
| Rate for Payer: Blue Distinction Transplant |
$59.74
|
| Rate for Payer: Blue Shield of California Commercial |
$62.62
|
| Rate for Payer: Blue Shield of California EPN |
$48.68
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Central Health Plan Commercial |
$79.65
|
| Rate for Payer: Cigna of CA HMO |
$63.72
|
| Rate for Payer: Cigna of CA PPO |
$73.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.63
|
| Rate for Payer: Dignity Health Media |
$84.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$74.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.91
|
| Rate for Payer: Multiplan Commercial |
$74.67
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
| Rate for Payer: Riverside University Health System MISP |
$39.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.78
|
| Rate for Payer: United Healthcare All Other HMO |
$49.78
|
| Rate for Payer: United Healthcare HMO Rider |
$49.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.63
|
| Rate for Payer: Vantage Medical Group Senior |
$84.63
|
|
|
HC CATH PERITONEAL DIALYSIS PEDS
|
Facility
|
IP
|
$99.56
|
|
| Hospital Charge Code |
901603645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$89.60 |
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Central Health Plan Commercial |
$79.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.82
|
| Rate for Payer: Galaxy Health WC |
$84.63
|
| Rate for Payer: Global Benefits Group Commercial |
$59.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.91
|
| Rate for Payer: Multiplan Commercial |
$74.67
|
| Rate for Payer: Networks By Design Commercial |
$64.71
|
| Rate for Payer: Prime Health Services Commercial |
$84.63
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Blue Shield of California EPN |
$786.05
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$555.83
|
| Rate for Payer: United Healthcare All Other HMO |
$542.87
|
| Rate for Payer: United Healthcare HMO Rider |
$531.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.76
|
|
|
HC CATH PHERESFLOW TRIPLE LUMEN
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$809.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$672.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$819.90
|
| Rate for Payer: Blue Distinction Transplant |
$883.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,104.00
|
| Rate for Payer: Blue Shield of California EPN |
$800.77
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Media |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,104.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Riverside University Health System MISP |
$588.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$736.00
|
| Rate for Payer: United Healthcare All Other HMO |
$736.00
|
| Rate for Payer: United Healthcare HMO Rider |
$736.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$736.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH PICC 4FR SL 55CM W/STYLET
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
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 PICC 4FR SL 55CM W/STYLET
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698799
|
|
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 PICC 5.5FR DL 55CM STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PICC 5.5FR DL 55CM STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH PICC 5FR DL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH PICC 5FR DL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
