|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Blue Shield of California EPN |
$660.77
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.24
|
| Rate for Payer: United Healthcare All Other HMO |
$456.35
|
| Rate for Payer: United Healthcare HMO Rider |
$446.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$408.34
|
|
|
HC CATH PICC POWER NVLST 5FR DL 50CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$680.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$565.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$689.23
|
| Rate for Payer: Blue Distinction Transplant |
$742.44
|
| Rate for Payer: Blue Shield of California Commercial |
$928.05
|
| Rate for Payer: Blue Shield of California EPN |
$673.15
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Media |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$928.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$433.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Riverside University Health System MISP |
$494.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$618.70
|
| Rate for Payer: United Healthcare All Other HMO |
$618.70
|
| Rate for Payer: United Healthcare HMO Rider |
$618.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$618.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
IP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Blue Shield of California EPN |
$660.77
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.24
|
| Rate for Payer: United Healthcare All Other HMO |
$456.35
|
| Rate for Payer: United Healthcare HMO Rider |
$446.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$408.34
|
|
|
HC CATH PICC POWER NVLST 5FR DL 55CM
|
Facility
|
OP
|
$1,237.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.48 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$680.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$680.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$565.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$689.23
|
| Rate for Payer: Blue Distinction Transplant |
$742.44
|
| Rate for Payer: Blue Shield of California Commercial |
$928.05
|
| Rate for Payer: Blue Shield of California EPN |
$673.15
|
| Rate for Payer: Cash Price |
$556.83
|
| Rate for Payer: Central Health Plan Commercial |
$989.92
|
| Rate for Payer: Cigna of CA HMO |
$866.18
|
| Rate for Payer: Cigna of CA PPO |
$866.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,051.79
|
| Rate for Payer: Dignity Health Media |
$1,051.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,051.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$494.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$494.96
|
| Rate for Payer: Galaxy Health WC |
$1,051.79
|
| Rate for Payer: Global Benefits Group Commercial |
$742.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,113.66
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$928.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$433.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$825.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$247.48
|
| Rate for Payer: Multiplan Commercial |
$928.05
|
| Rate for Payer: Networks By Design Commercial |
$618.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,051.79
|
| Rate for Payer: Riverside University Health System MISP |
$494.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$742.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$618.70
|
| Rate for Payer: United Healthcare All Other HMO |
$618.70
|
| Rate for Payer: United Healthcare HMO Rider |
$618.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$618.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,051.79
|
| Rate for Payer: Vantage Medical Group Senior |
$1,051.79
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$430.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$378.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$462.01
|
| Rate for Payer: Blue Distinction Transplant |
$469.20
|
| Rate for Payer: Blue Shield of California Commercial |
$491.88
|
| Rate for Payer: Blue Shield of California EPN |
$382.40
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$500.48
|
| Rate for Payer: Cigna of CA PPO |
$578.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Media |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$586.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$273.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Riverside University Health System MISP |
$312.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC CATH PICC POWER TLS 5FR DL
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Blue Shield of California EPN |
$393.02
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$515.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.40
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$490.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$277.91
|
| Rate for Payer: United Healthcare All Other HMO |
$271.44
|
| Rate for Payer: United Healthcare HMO Rider |
$265.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$242.88
|
|
|
HC CATH PICC POWER TLS 5FR SL
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$404.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$404.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$409.95
|
| Rate for Payer: Blue Distinction Transplant |
$441.60
|
| Rate for Payer: Blue Shield of California Commercial |
$552.00
|
| Rate for Payer: Blue Shield of California EPN |
$400.38
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$515.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.60
|
| Rate for Payer: Dignity Health Media |
$625.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$625.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.40
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$552.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$257.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$490.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Networks By Design Commercial |
$368.00
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
| Rate for Payer: Riverside University Health System MISP |
$294.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$441.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$441.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$368.00
|
| Rate for Payer: United Healthcare All Other HMO |
$368.00
|
| Rate for Payer: United Healthcare HMO Rider |
$368.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$368.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$625.60
|
| Rate for Payer: Vantage Medical Group Senior |
$625.60
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
IP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$824.90 |
| Rate for Payer: Blue Shield of California EPN |
$489.44
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Central Health Plan Commercial |
$733.24
|
| Rate for Payer: Cigna of CA HMO |
$641.58
|
| Rate for Payer: Cigna of CA PPO |
$641.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$824.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.31
|
| Rate for Payer: Multiplan Commercial |
$687.41
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.09
|
| Rate for Payer: United Healthcare All Other HMO |
$338.02
|
| Rate for Payer: United Healthcare HMO Rider |
$330.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.46
|
|
|
HC CATH PICC PROVENA 3FR SL MAX
|
Facility
|
OP
|
$916.55
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.31 |
| Max. Negotiated Rate |
$824.90 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$779.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$504.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$504.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$418.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$510.52
|
| Rate for Payer: Blue Distinction Transplant |
$549.93
|
| Rate for Payer: Blue Shield of California Commercial |
$687.41
|
| Rate for Payer: Blue Shield of California EPN |
$498.60
|
| Rate for Payer: Cash Price |
$412.45
|
| Rate for Payer: Central Health Plan Commercial |
$733.24
|
| Rate for Payer: Cigna of CA HMO |
$641.58
|
| Rate for Payer: Cigna of CA PPO |
$641.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$779.07
|
| Rate for Payer: Dignity Health Media |
$779.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$779.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$366.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$366.62
|
| Rate for Payer: Galaxy Health WC |
$779.07
|
| Rate for Payer: Global Benefits Group Commercial |
$549.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$824.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$687.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$320.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$611.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$349.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.31
|
| Rate for Payer: Multiplan Commercial |
$687.41
|
| Rate for Payer: Networks By Design Commercial |
$458.28
|
| Rate for Payer: Prime Health Services Commercial |
$779.07
|
| Rate for Payer: Riverside University Health System MISP |
$366.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$549.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$549.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$458.28
|
| Rate for Payer: United Healthcare All Other HMO |
$458.28
|
| Rate for Payer: United Healthcare HMO Rider |
$458.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$779.07
|
| Rate for Payer: Vantage Medical Group Senior |
$779.07
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
OP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$846.63 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$517.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$429.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$523.97
|
| Rate for Payer: Blue Distinction Transplant |
$564.42
|
| Rate for Payer: Blue Shield of California Commercial |
$705.52
|
| Rate for Payer: Blue Shield of California EPN |
$511.74
|
| Rate for Payer: Cash Price |
$423.32
|
| Rate for Payer: Central Health Plan Commercial |
$752.56
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.60
|
| Rate for Payer: Dignity Health Media |
$799.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$846.63
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$705.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$329.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.14
|
| Rate for Payer: Multiplan Commercial |
$705.52
|
| Rate for Payer: Networks By Design Commercial |
$470.35
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$376.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.35
|
| Rate for Payer: United Healthcare All Other HMO |
$470.35
|
| Rate for Payer: United Healthcare HMO Rider |
$470.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.60
|
| Rate for Payer: Vantage Medical Group Senior |
$799.60
|
|
|
HC CATH PICC PROVENA 4FR DL MAX
|
Facility
|
IP
|
$940.70
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$846.63 |
| Rate for Payer: Blue Shield of California EPN |
$502.33
|
| Rate for Payer: Cash Price |
$423.32
|
| Rate for Payer: Central Health Plan Commercial |
$752.56
|
| Rate for Payer: Cigna of CA HMO |
$658.49
|
| Rate for Payer: Cigna of CA PPO |
$658.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$376.28
|
| Rate for Payer: Galaxy Health WC |
$799.60
|
| Rate for Payer: Global Benefits Group Commercial |
$564.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$846.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.14
|
| Rate for Payer: Multiplan Commercial |
$705.52
|
| Rate for Payer: Prime Health Services Commercial |
$799.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$355.21
|
| Rate for Payer: United Healthcare All Other HMO |
$346.93
|
| Rate for Payer: United Healthcare HMO Rider |
$339.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.43
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
OP
|
$1,608.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.71 |
| Max. Negotiated Rate |
$1,447.68 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,367.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$884.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$884.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$734.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$895.95
|
| Rate for Payer: Blue Distinction Transplant |
$965.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,206.40
|
| Rate for Payer: Blue Shield of California EPN |
$875.04
|
| Rate for Payer: Cash Price |
$723.84
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.82
|
| Rate for Payer: Cigna of CA HMO |
$1,125.97
|
| Rate for Payer: Cigna of CA PPO |
$1,125.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,367.25
|
| Rate for Payer: Dignity Health Media |
$1,367.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,367.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$643.41
|
| Rate for Payer: Galaxy Health WC |
$1,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$965.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$562.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.71
|
| Rate for Payer: Multiplan Commercial |
$1,206.40
|
| Rate for Payer: Networks By Design Commercial |
$804.26
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.25
|
| Rate for Payer: Riverside University Health System MISP |
$643.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$965.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$965.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.26
|
| Rate for Payer: United Healthcare All Other HMO |
$804.26
|
| Rate for Payer: United Healthcare HMO Rider |
$804.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,367.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,367.25
|
|
|
HC CATH PICC PWR 4.5FR 45CM SL
|
Facility
|
IP
|
$1,608.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.71 |
| Max. Negotiated Rate |
$1,447.68 |
| Rate for Payer: Blue Shield of California EPN |
$858.96
|
| Rate for Payer: Cash Price |
$723.84
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.82
|
| Rate for Payer: Cigna of CA HMO |
$1,125.97
|
| Rate for Payer: Cigna of CA PPO |
$1,125.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$643.41
|
| Rate for Payer: Galaxy Health WC |
$1,367.25
|
| Rate for Payer: Global Benefits Group Commercial |
$965.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.71
|
| Rate for Payer: Multiplan Commercial |
$1,206.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$607.38
|
| Rate for Payer: United Healthcare All Other HMO |
$593.23
|
| Rate for Payer: United Healthcare HMO Rider |
$580.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.81
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
OP
|
$1,410.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.07 |
| Max. Negotiated Rate |
$1,269.32 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,198.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$775.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$775.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$643.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$785.57
|
| Rate for Payer: Blue Distinction Transplant |
$846.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,057.77
|
| Rate for Payer: Blue Shield of California EPN |
$767.24
|
| Rate for Payer: Cash Price |
$634.66
|
| Rate for Payer: Central Health Plan Commercial |
$1,128.29
|
| Rate for Payer: Cigna of CA HMO |
$987.25
|
| Rate for Payer: Cigna of CA PPO |
$987.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,198.81
|
| Rate for Payer: Dignity Health Media |
$1,198.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,198.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$564.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$564.14
|
| Rate for Payer: Galaxy Health WC |
$1,198.81
|
| Rate for Payer: Global Benefits Group Commercial |
$846.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,269.32
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,057.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$493.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$940.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$537.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.07
|
| Rate for Payer: Multiplan Commercial |
$1,057.77
|
| Rate for Payer: Networks By Design Commercial |
$705.18
|
| Rate for Payer: Prime Health Services Commercial |
$1,198.81
|
| Rate for Payer: Riverside University Health System MISP |
$564.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$846.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$846.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$705.18
|
| Rate for Payer: United Healthcare All Other HMO |
$705.18
|
| Rate for Payer: United Healthcare HMO Rider |
$705.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$705.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,198.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,198.81
|
|
|
HC CATH PICC PWR 4.5FR 50CM SL
|
Facility
|
IP
|
$1,410.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.07 |
| Max. Negotiated Rate |
$1,269.32 |
| Rate for Payer: Blue Shield of California EPN |
$753.13
|
| Rate for Payer: Cash Price |
$634.66
|
| Rate for Payer: Central Health Plan Commercial |
$1,128.29
|
| Rate for Payer: Cigna of CA HMO |
$987.25
|
| Rate for Payer: Cigna of CA PPO |
$987.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$564.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$564.14
|
| Rate for Payer: Galaxy Health WC |
$1,198.81
|
| Rate for Payer: Global Benefits Group Commercial |
$846.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,269.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$940.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$537.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.07
|
| Rate for Payer: Multiplan Commercial |
$1,057.77
|
| Rate for Payer: Prime Health Services Commercial |
$1,198.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$532.55
|
| Rate for Payer: United Healthcare All Other HMO |
$520.14
|
| Rate for Payer: United Healthcare HMO Rider |
$508.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$465.42
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
IP
|
$1,405.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.17 |
| Max. Negotiated Rate |
$1,265.26 |
| Rate for Payer: Blue Shield of California EPN |
$750.72
|
| Rate for Payer: Cash Price |
$632.63
|
| Rate for Payer: Central Health Plan Commercial |
$1,124.68
|
| Rate for Payer: Cigna of CA HMO |
$984.10
|
| Rate for Payer: Cigna of CA PPO |
$984.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$562.34
|
| Rate for Payer: Galaxy Health WC |
$1,194.97
|
| Rate for Payer: Global Benefits Group Commercial |
$843.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,265.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$937.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.17
|
| Rate for Payer: Multiplan Commercial |
$1,054.39
|
| Rate for Payer: Prime Health Services Commercial |
$1,194.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$530.85
|
| Rate for Payer: United Healthcare All Other HMO |
$518.48
|
| Rate for Payer: United Healthcare HMO Rider |
$507.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$463.93
|
|
|
HC CATH PICC PWR 4.5FR 55CM SL
|
Facility
|
OP
|
$1,405.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.17 |
| Max. Negotiated Rate |
$1,265.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,194.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$773.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$641.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$783.06
|
| Rate for Payer: Blue Distinction Transplant |
$843.51
|
| Rate for Payer: Blue Shield of California Commercial |
$1,054.39
|
| Rate for Payer: Blue Shield of California EPN |
$764.78
|
| Rate for Payer: Cash Price |
$632.63
|
| Rate for Payer: Central Health Plan Commercial |
$1,124.68
|
| Rate for Payer: Cigna of CA HMO |
$984.10
|
| Rate for Payer: Cigna of CA PPO |
$984.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,194.97
|
| Rate for Payer: Dignity Health Media |
$1,194.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,194.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$562.34
|
| Rate for Payer: Galaxy Health WC |
$1,194.97
|
| Rate for Payer: Global Benefits Group Commercial |
$843.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,265.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,054.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$492.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$937.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.17
|
| Rate for Payer: Multiplan Commercial |
$1,054.39
|
| Rate for Payer: Networks By Design Commercial |
$702.92
|
| Rate for Payer: Prime Health Services Commercial |
$1,194.97
|
| Rate for Payer: Riverside University Health System MISP |
$562.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$843.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$843.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$702.92
|
| Rate for Payer: United Healthcare All Other HMO |
$702.92
|
| Rate for Payer: United Healthcare HMO Rider |
$702.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$702.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,194.97
|
| Rate for Payer: Vantage Medical Group Senior |
$1,194.97
|
|
|
HC CATH PICC PWR 4.5FR SL 40CM
|
Facility
|
IP
|
$1,329.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
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 PWR 4.5FR SL 40CM
|
Facility
|
OP
|
$1,329.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607738
|
|
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 PWR 4FR SL
|
Facility
|
IP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Blue Shield of California EPN |
$682.27
|
| Rate for Payer: Cash Price |
$574.94
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$852.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$482.44
|
| Rate for Payer: United Healthcare All Other HMO |
$471.20
|
| Rate for Payer: United Healthcare HMO Rider |
$460.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.62
|
|
|
HC CATH PICC PWR 4FR SL
|
Facility
|
OP
|
$1,277.65
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$1,149.88 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$702.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$583.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$711.65
|
| Rate for Payer: Blue Distinction Transplant |
$766.59
|
| Rate for Payer: Blue Shield of California Commercial |
$958.24
|
| Rate for Payer: Blue Shield of California EPN |
$695.04
|
| Rate for Payer: Cash Price |
$574.94
|
| Rate for Payer: Central Health Plan Commercial |
$1,022.12
|
| Rate for Payer: Cigna of CA HMO |
$894.36
|
| Rate for Payer: Cigna of CA PPO |
$894.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,086.00
|
| Rate for Payer: Dignity Health Media |
$1,086.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,086.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$511.06
|
| Rate for Payer: Galaxy Health WC |
$1,086.00
|
| Rate for Payer: Global Benefits Group Commercial |
$766.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,149.88
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$958.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$447.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$852.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$486.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.53
|
| Rate for Payer: Multiplan Commercial |
$958.24
|
| Rate for Payer: Networks By Design Commercial |
$638.82
|
| Rate for Payer: Prime Health Services Commercial |
$1,086.00
|
| Rate for Payer: Riverside University Health System MISP |
$511.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$766.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$766.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$638.82
|
| Rate for Payer: United Healthcare All Other HMO |
$638.82
|
| Rate for Payer: United Healthcare HMO Rider |
$638.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$638.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,086.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,086.00
|
|
|
HC CATH PICC PWR 4FR SL 40CM VPS
|
Facility
|
IP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607737
|
|
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 PWR 4FR SL 40CM VPS
|
Facility
|
OP
|
$1,168.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607737
|
|
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 PWR 5.5FR 45CM DL
|
Facility
|
OP
|
$1,717.18
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698202
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.44 |
| Max. Negotiated Rate |
$1,545.46 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$944.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$944.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$784.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$956.47
|
| Rate for Payer: Blue Distinction Transplant |
$1,030.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1,287.88
|
| Rate for Payer: Blue Shield of California EPN |
$934.15
|
| Rate for Payer: Cash Price |
$772.73
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.74
|
| Rate for Payer: Cigna of CA HMO |
$1,202.03
|
| Rate for Payer: Cigna of CA PPO |
$1,202.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,459.60
|
| Rate for Payer: Dignity Health Media |
$1,459.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,459.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$686.87
|
| Rate for Payer: Galaxy Health WC |
$1,459.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,287.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$601.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,145.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$654.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.44
|
| Rate for Payer: Multiplan Commercial |
$1,287.88
|
| Rate for Payer: Networks By Design Commercial |
$858.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.60
|
| Rate for Payer: Riverside University Health System MISP |
$686.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,030.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,030.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$858.59
|
| Rate for Payer: United Healthcare All Other HMO |
$858.59
|
| Rate for Payer: United Healthcare HMO Rider |
$858.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$858.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,459.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,459.60
|
|
