|
HC CATH PICC 6FR TL 55CM W/STYLET
|
Facility
|
OP
|
$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: 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 DUAL LUMEN 1.9FR
|
Facility
|
IP
|
$555.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$499.55 |
| Rate for Payer: Blue Shield of California EPN |
$296.40
|
| Rate for Payer: Cash Price |
$249.78
|
| Rate for Payer: Central Health Plan Commercial |
$444.05
|
| Rate for Payer: Cigna of CA HMO |
$388.54
|
| Rate for Payer: Cigna of CA PPO |
$388.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$222.02
|
| Rate for Payer: Galaxy Health WC |
$471.80
|
| Rate for Payer: Global Benefits Group Commercial |
$333.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$499.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$370.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.01
|
| Rate for Payer: Multiplan Commercial |
$416.30
|
| Rate for Payer: Prime Health Services Commercial |
$471.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.59
|
| Rate for Payer: United Healthcare All Other HMO |
$204.71
|
| Rate for Payer: United Healthcare HMO Rider |
$200.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$183.17
|
|
|
HC CATH PICC DUAL LUMEN 1.9FR
|
Facility
|
OP
|
$555.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$499.55 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$471.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$253.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$309.17
|
| Rate for Payer: Blue Distinction Transplant |
$333.04
|
| Rate for Payer: Blue Shield of California Commercial |
$416.30
|
| Rate for Payer: Blue Shield of California EPN |
$301.95
|
| Rate for Payer: Cash Price |
$249.78
|
| Rate for Payer: Central Health Plan Commercial |
$444.05
|
| Rate for Payer: Cigna of CA HMO |
$388.54
|
| Rate for Payer: Cigna of CA PPO |
$388.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$471.80
|
| Rate for Payer: Dignity Health Media |
$471.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$471.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$222.02
|
| Rate for Payer: Galaxy Health WC |
$471.80
|
| Rate for Payer: Global Benefits Group Commercial |
$333.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$499.55
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$416.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$194.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$370.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.01
|
| Rate for Payer: Multiplan Commercial |
$416.30
|
| Rate for Payer: Networks By Design Commercial |
$277.53
|
| Rate for Payer: Prime Health Services Commercial |
$471.80
|
| Rate for Payer: Riverside University Health System MISP |
$222.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$333.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$277.53
|
| Rate for Payer: United Healthcare All Other HMO |
$277.53
|
| Rate for Payer: United Healthcare HMO Rider |
$277.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$277.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$471.80
|
| Rate for Payer: Vantage Medical Group Senior |
$471.80
|
|
|
HC CATH PICC INS TRAY NEONATAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: Blue Distinction Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Media |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC INS TRAY NEONATAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
IP
|
$933.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.71 |
| Max. Negotiated Rate |
$840.21 |
| Rate for Payer: Blue Shield of California EPN |
$498.53
|
| Rate for Payer: Cash Price |
$420.11
|
| Rate for Payer: Central Health Plan Commercial |
$746.86
|
| Rate for Payer: Cigna of CA HMO |
$653.50
|
| Rate for Payer: Cigna of CA PPO |
$653.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.43
|
| Rate for Payer: Galaxy Health WC |
$793.53
|
| Rate for Payer: Global Benefits Group Commercial |
$560.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.71
|
| Rate for Payer: Multiplan Commercial |
$700.18
|
| Rate for Payer: Prime Health Services Commercial |
$793.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.52
|
| Rate for Payer: United Healthcare All Other HMO |
$344.30
|
| Rate for Payer: United Healthcare HMO Rider |
$336.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.08
|
|
|
HC CATH PICC KIT 3FR 1 LUMEN
|
Facility
|
OP
|
$933.57
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698387
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.71 |
| Max. Negotiated Rate |
$840.21 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$793.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$513.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$513.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$426.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$520.00
|
| Rate for Payer: Blue Distinction Transplant |
$560.14
|
| Rate for Payer: Blue Shield of California Commercial |
$700.18
|
| Rate for Payer: Blue Shield of California EPN |
$507.86
|
| Rate for Payer: Cash Price |
$420.11
|
| Rate for Payer: Central Health Plan Commercial |
$746.86
|
| Rate for Payer: Cigna of CA HMO |
$653.50
|
| Rate for Payer: Cigna of CA PPO |
$653.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$793.53
|
| Rate for Payer: Dignity Health Media |
$793.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$793.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.43
|
| Rate for Payer: Galaxy Health WC |
$793.53
|
| Rate for Payer: Global Benefits Group Commercial |
$560.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$700.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$326.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.71
|
| Rate for Payer: Multiplan Commercial |
$700.18
|
| Rate for Payer: Networks By Design Commercial |
$466.78
|
| Rate for Payer: Prime Health Services Commercial |
$793.53
|
| Rate for Payer: Riverside University Health System MISP |
$373.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$560.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$560.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.78
|
| Rate for Payer: United Healthcare All Other HMO |
$466.78
|
| Rate for Payer: United Healthcare HMO Rider |
$466.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$466.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$793.53
|
| Rate for Payer: Vantage Medical Group Senior |
$793.53
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
OP
|
$1,329.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.88 |
| Max. Negotiated Rate |
$1,196.46 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,129.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$731.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$607.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$740.48
|
| Rate for Payer: Blue Distinction Transplant |
$797.64
|
| Rate for Payer: Blue Shield of California Commercial |
$997.05
|
| Rate for Payer: Blue Shield of California EPN |
$723.19
|
| Rate for Payer: Cash Price |
$598.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,063.52
|
| Rate for Payer: Cigna of CA HMO |
$930.58
|
| Rate for Payer: Cigna of CA PPO |
$930.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,129.99
|
| Rate for Payer: Dignity Health Media |
$1,129.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,129.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$531.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$531.76
|
| Rate for Payer: Galaxy Health WC |
$1,129.99
|
| Rate for Payer: Global Benefits Group Commercial |
$797.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,196.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$997.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$465.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$886.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$506.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.88
|
| Rate for Payer: Multiplan Commercial |
$997.05
|
| Rate for Payer: Networks By Design Commercial |
$664.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,129.99
|
| Rate for Payer: Riverside University Health System MISP |
$531.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$797.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$797.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$664.70
|
| Rate for Payer: United Healthcare All Other HMO |
$664.70
|
| Rate for Payer: United Healthcare HMO Rider |
$664.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,129.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,129.99
|
|
|
HC CATH PICC NAVICURVE SL 4.5FR
|
Facility
|
IP
|
$1,329.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.88 |
| Max. Negotiated Rate |
$1,196.46 |
| Rate for Payer: Blue Shield of California EPN |
$709.90
|
| Rate for Payer: Cash Price |
$598.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,063.52
|
| Rate for Payer: Cigna of CA HMO |
$930.58
|
| Rate for Payer: Cigna of CA PPO |
$930.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$531.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$531.76
|
| Rate for Payer: Galaxy Health WC |
$1,129.99
|
| Rate for Payer: Global Benefits Group Commercial |
$797.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,196.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$886.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$506.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.88
|
| Rate for Payer: Multiplan Commercial |
$997.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,129.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$501.98
|
| Rate for Payer: United Healthcare All Other HMO |
$490.28
|
| Rate for Payer: United Healthcare HMO Rider |
$479.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$438.70
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$194.95
|
| Rate for Payer: Blue Distinction Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$262.50
|
| Rate for Payer: Blue Shield of California EPN |
$190.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Media |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC NEONATAL 1.9FR 50CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Blue Shield of California EPN |
$186.90
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.16
|
| Rate for Payer: United Healthcare All Other HMO |
$129.08
|
| Rate for Payer: United Healthcare HMO Rider |
$126.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.50
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$194.95
|
| Rate for Payer: Blue Distinction Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$262.50
|
| Rate for Payer: Blue Shield of California EPN |
$190.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Media |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC CATH PICC POLYURETHANE 1.4FR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Blue Shield of California EPN |
$186.90
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.16
|
| Rate for Payer: United Healthcare All Other HMO |
$129.08
|
| Rate for Payer: United Healthcare HMO Rider |
$126.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.50
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$993.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$642.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$642.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$533.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$650.80
|
| Rate for Payer: Blue Distinction Transplant |
$701.04
|
| Rate for Payer: Blue Shield of California Commercial |
$876.30
|
| Rate for Payer: Blue Shield of California EPN |
$635.61
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$993.14
|
| Rate for Payer: Dignity Health Media |
$993.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$993.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$876.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Networks By Design Commercial |
$584.20
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: Riverside University Health System MISP |
$467.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$701.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$701.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$584.20
|
| Rate for Payer: United Healthcare All Other HMO |
$584.20
|
| Rate for Payer: United Healthcare HMO Rider |
$584.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$584.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$993.14
|
| Rate for Payer: Vantage Medical Group Senior |
$993.14
|
|
|
HC CATH PICC POWER 4FR 55CM
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$233.68 |
| Max. Negotiated Rate |
$1,051.56 |
| Rate for Payer: Blue Shield of California EPN |
$623.93
|
| Rate for Payer: Cash Price |
$525.78
|
| Rate for Payer: Central Health Plan Commercial |
$934.72
|
| Rate for Payer: Cigna of CA HMO |
$817.88
|
| Rate for Payer: Cigna of CA PPO |
$817.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$467.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$467.36
|
| Rate for Payer: Galaxy Health WC |
$993.14
|
| Rate for Payer: Global Benefits Group Commercial |
$701.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$779.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.68
|
| Rate for Payer: Multiplan Commercial |
$876.30
|
| Rate for Payer: Prime Health Services Commercial |
$993.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$441.19
|
| Rate for Payer: United Healthcare All Other HMO |
$430.91
|
| Rate for Payer: United Healthcare HMO Rider |
$421.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$385.57
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
IP
|
$967.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$193.45 |
| Max. Negotiated Rate |
$870.52 |
| Rate for Payer: Blue Shield of California EPN |
$516.51
|
| Rate for Payer: Cash Price |
$435.26
|
| Rate for Payer: Central Health Plan Commercial |
$773.79
|
| Rate for Payer: Cigna of CA HMO |
$677.07
|
| Rate for Payer: Cigna of CA PPO |
$677.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$386.90
|
| Rate for Payer: Galaxy Health WC |
$822.15
|
| Rate for Payer: Global Benefits Group Commercial |
$580.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$870.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$645.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.45
|
| Rate for Payer: Multiplan Commercial |
$725.43
|
| Rate for Payer: Prime Health Services Commercial |
$822.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$365.23
|
| Rate for Payer: United Healthcare All Other HMO |
$356.72
|
| Rate for Payer: United Healthcare HMO Rider |
$348.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$319.19
|
|
|
HC CATH PICC POWER 4FR DL
|
Facility
|
OP
|
$967.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698105
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$193.45 |
| Max. Negotiated Rate |
$870.52 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$822.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$531.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$531.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$441.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$538.75
|
| Rate for Payer: Blue Distinction Transplant |
$580.34
|
| Rate for Payer: Blue Shield of California Commercial |
$725.43
|
| Rate for Payer: Blue Shield of California EPN |
$526.18
|
| Rate for Payer: Cash Price |
$435.26
|
| Rate for Payer: Central Health Plan Commercial |
$773.79
|
| Rate for Payer: Cigna of CA HMO |
$677.07
|
| Rate for Payer: Cigna of CA PPO |
$677.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$822.15
|
| Rate for Payer: Dignity Health Media |
$822.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$822.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$386.90
|
| Rate for Payer: Galaxy Health WC |
$822.15
|
| Rate for Payer: Global Benefits Group Commercial |
$580.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$870.52
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$725.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$338.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$645.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.45
|
| Rate for Payer: Multiplan Commercial |
$725.43
|
| Rate for Payer: Networks By Design Commercial |
$483.62
|
| Rate for Payer: Prime Health Services Commercial |
$822.15
|
| Rate for Payer: Riverside University Health System MISP |
$386.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$580.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$580.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$483.62
|
| Rate for Payer: United Healthcare All Other HMO |
$483.62
|
| Rate for Payer: United Healthcare HMO Rider |
$483.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$483.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$822.15
|
| Rate for Payer: Vantage Medical Group Senior |
$822.15
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
IP
|
$1,235.61
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.12 |
| Max. Negotiated Rate |
$1,112.05 |
| Rate for Payer: Blue Shield of California EPN |
$659.82
|
| Rate for Payer: Cash Price |
$556.02
|
| Rate for Payer: Central Health Plan Commercial |
$988.49
|
| Rate for Payer: Cigna of CA HMO |
$864.93
|
| Rate for Payer: Cigna of CA PPO |
$864.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.24
|
| Rate for Payer: Galaxy Health WC |
$1,050.27
|
| Rate for Payer: Global Benefits Group Commercial |
$741.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,112.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$824.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.12
|
| Rate for Payer: Multiplan Commercial |
$926.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,050.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$466.57
|
| Rate for Payer: United Healthcare All Other HMO |
$455.69
|
| Rate for Payer: United Healthcare HMO Rider |
$445.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.75
|
|
|
HC CATH PICC POWER 4FR SL 50CM
|
Facility
|
OP
|
$1,235.61
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.12 |
| Max. Negotiated Rate |
$1,112.05 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,050.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$679.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$679.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$564.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$688.23
|
| Rate for Payer: Blue Distinction Transplant |
$741.37
|
| Rate for Payer: Blue Shield of California Commercial |
$926.71
|
| Rate for Payer: Blue Shield of California EPN |
$672.17
|
| Rate for Payer: Cash Price |
$556.02
|
| Rate for Payer: Central Health Plan Commercial |
$988.49
|
| Rate for Payer: Cigna of CA HMO |
$864.93
|
| Rate for Payer: Cigna of CA PPO |
$864.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,050.27
|
| Rate for Payer: Dignity Health Media |
$1,050.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,050.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.24
|
| Rate for Payer: Galaxy Health WC |
$1,050.27
|
| Rate for Payer: Global Benefits Group Commercial |
$741.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,112.05
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$926.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$432.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$824.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.12
|
| Rate for Payer: Multiplan Commercial |
$926.71
|
| Rate for Payer: Networks By Design Commercial |
$617.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,050.27
|
| Rate for Payer: Riverside University Health System MISP |
$494.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$741.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$741.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$617.80
|
| Rate for Payer: United Healthcare All Other HMO |
$617.80
|
| Rate for Payer: United Healthcare HMO Rider |
$617.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$617.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,050.27
|
| Rate for Payer: Vantage Medical Group Senior |
$1,050.27
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$543.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$543.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$451.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$550.87
|
| Rate for Payer: Blue Distinction Transplant |
$593.40
|
| Rate for Payer: Blue Shield of California Commercial |
$741.75
|
| Rate for Payer: Blue Shield of California EPN |
$538.02
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$840.65
|
| Rate for Payer: Dignity Health Media |
$840.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$840.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$741.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$346.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$494.50
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Riverside University Health System MISP |
$395.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.50
|
| Rate for Payer: United Healthcare All Other HMO |
$494.50
|
| Rate for Payer: United Healthcare HMO Rider |
$494.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$494.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$840.65
|
| Rate for Payer: Vantage Medical Group Senior |
$840.65
|
|
|
HC CATH PICC POWER 6FR TL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Blue Shield of California EPN |
$528.13
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$692.30
|
| Rate for Payer: Cigna of CA PPO |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$373.45
|
| Rate for Payer: United Healthcare All Other HMO |
$364.74
|
| Rate for Payer: United Healthcare HMO Rider |
$356.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.37
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Blue Shield of California EPN |
$685.34
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$484.61
|
| Rate for Payer: United Healthcare All Other HMO |
$473.32
|
| Rate for Payer: United Healthcare HMO Rider |
$463.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$423.52
|
|
|
HC CATH PICC POWER 6FR TL 50CM
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$586.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$714.85
|
| Rate for Payer: Blue Distinction Transplant |
$770.04
|
| Rate for Payer: Blue Shield of California Commercial |
$962.55
|
| Rate for Payer: Blue Shield of California EPN |
$698.17
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Media |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$962.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$449.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Riverside University Health System MISP |
$513.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$641.70
|
| Rate for Payer: United Healthcare All Other HMO |
$641.70
|
| Rate for Payer: United Healthcare HMO Rider |
$641.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
IP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Blue Shield of California EPN |
$685.34
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$484.61
|
| Rate for Payer: United Healthcare All Other HMO |
$473.32
|
| Rate for Payer: United Healthcare HMO Rider |
$463.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$423.52
|
|
|
HC CATH PICC POWER 6FR TL 55CM
|
Facility
|
OP
|
$1,283.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.68 |
| Max. Negotiated Rate |
$1,155.06 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$705.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$586.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$714.85
|
| Rate for Payer: Blue Distinction Transplant |
$770.04
|
| Rate for Payer: Blue Shield of California Commercial |
$962.55
|
| Rate for Payer: Blue Shield of California EPN |
$698.17
|
| Rate for Payer: Cash Price |
$577.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,026.72
|
| Rate for Payer: Cigna of CA HMO |
$898.38
|
| Rate for Payer: Cigna of CA PPO |
$898.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,090.89
|
| Rate for Payer: Dignity Health Media |
$1,090.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,090.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$513.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$513.36
|
| Rate for Payer: Galaxy Health WC |
$1,090.89
|
| Rate for Payer: Global Benefits Group Commercial |
$770.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,155.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$962.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$449.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$856.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.68
|
| Rate for Payer: Multiplan Commercial |
$962.55
|
| Rate for Payer: Networks By Design Commercial |
$641.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,090.89
|
| Rate for Payer: Riverside University Health System MISP |
$513.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$770.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$770.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$641.70
|
| Rate for Payer: United Healthcare All Other HMO |
$641.70
|
| Rate for Payer: United Healthcare HMO Rider |
$641.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,090.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1,090.89
|
|
