|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
OP
|
$109.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.98 |
| Max. Negotiated Rate |
$98.91 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.21
|
| Rate for Payer: Blue Distinction Transplant |
$65.94
|
| Rate for Payer: Blue Shield of California Commercial |
$82.42
|
| Rate for Payer: Blue Shield of California EPN |
$59.79
|
| Rate for Payer: Cash Price |
$49.46
|
| Rate for Payer: Central Health Plan Commercial |
$87.92
|
| Rate for Payer: Cigna of CA HMO |
$76.93
|
| Rate for Payer: Cigna of CA PPO |
$76.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.42
|
| Rate for Payer: Dignity Health Media |
$93.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.96
|
| Rate for Payer: Galaxy Health WC |
$93.42
|
| Rate for Payer: Global Benefits Group Commercial |
$65.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.91
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$82.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.98
|
| Rate for Payer: Multiplan Commercial |
$82.42
|
| Rate for Payer: Networks By Design Commercial |
$54.95
|
| Rate for Payer: Prime Health Services Commercial |
$93.42
|
| Rate for Payer: Riverside University Health System MISP |
$43.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$54.95
|
| Rate for Payer: United Healthcare All Other HMO |
$54.95
|
| Rate for Payer: United Healthcare HMO Rider |
$54.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.42
|
| Rate for Payer: Vantage Medical Group Senior |
$93.42
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
IP
|
$109.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.98 |
| Max. Negotiated Rate |
$98.91 |
| Rate for Payer: Blue Shield of California EPN |
$58.69
|
| Rate for Payer: Cash Price |
$49.46
|
| Rate for Payer: Central Health Plan Commercial |
$87.92
|
| Rate for Payer: Cigna of CA HMO |
$76.93
|
| Rate for Payer: Cigna of CA PPO |
$76.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.96
|
| Rate for Payer: Galaxy Health WC |
$93.42
|
| Rate for Payer: Global Benefits Group Commercial |
$65.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.98
|
| Rate for Payer: Multiplan Commercial |
$82.42
|
| Rate for Payer: Prime Health Services Commercial |
$93.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.50
|
| Rate for Payer: United Healthcare All Other HMO |
$40.53
|
| Rate for Payer: United Healthcare HMO Rider |
$39.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.27
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
IP
|
$104.73
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Blue Shield of California EPN |
$55.93
|
| Rate for Payer: Cash Price |
$47.13
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: Cigna of CA HMO |
$73.31
|
| Rate for Payer: Cigna of CA PPO |
$73.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.55
|
| Rate for Payer: United Healthcare All Other HMO |
$38.62
|
| Rate for Payer: United Healthcare HMO Rider |
$37.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.56
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
OP
|
$104.73
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$94.26 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.33
|
| Rate for Payer: Blue Distinction Transplant |
$62.84
|
| Rate for Payer: Blue Shield of California Commercial |
$78.55
|
| Rate for Payer: Blue Shield of California EPN |
$56.97
|
| Rate for Payer: Cash Price |
$47.13
|
| Rate for Payer: Central Health Plan Commercial |
$83.78
|
| Rate for Payer: Cigna of CA HMO |
$73.31
|
| Rate for Payer: Cigna of CA PPO |
$73.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: Dignity Health Media |
$89.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.89
|
| Rate for Payer: Galaxy Health WC |
$89.02
|
| Rate for Payer: Global Benefits Group Commercial |
$62.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$78.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$78.55
|
| Rate for Payer: Networks By Design Commercial |
$52.36
|
| Rate for Payer: Prime Health Services Commercial |
$89.02
|
| Rate for Payer: Riverside University Health System MISP |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.36
|
| Rate for Payer: United Healthcare All Other HMO |
$52.36
|
| Rate for Payer: United Healthcare HMO Rider |
$52.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.02
|
| Rate for Payer: Vantage Medical Group Senior |
$89.02
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
IP
|
$109.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.81 |
| Max. Negotiated Rate |
$98.15 |
| Rate for Payer: Blue Shield of California EPN |
$58.24
|
| Rate for Payer: Cash Price |
$49.08
|
| Rate for Payer: Central Health Plan Commercial |
$87.25
|
| Rate for Payer: Cigna of CA HMO |
$76.34
|
| Rate for Payer: Cigna of CA PPO |
$76.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.62
|
| Rate for Payer: Galaxy Health WC |
$92.70
|
| Rate for Payer: Global Benefits Group Commercial |
$65.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.81
|
| Rate for Payer: Multiplan Commercial |
$81.80
|
| Rate for Payer: Prime Health Services Commercial |
$92.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.18
|
| Rate for Payer: United Healthcare All Other HMO |
$40.22
|
| Rate for Payer: United Healthcare HMO Rider |
$39.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.99
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
OP
|
$109.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.81 |
| Max. Negotiated Rate |
$98.15 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$92.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.75
|
| Rate for Payer: Blue Distinction Transplant |
$65.44
|
| Rate for Payer: Blue Shield of California Commercial |
$81.80
|
| Rate for Payer: Blue Shield of California EPN |
$59.33
|
| Rate for Payer: Cash Price |
$49.08
|
| Rate for Payer: Central Health Plan Commercial |
$87.25
|
| Rate for Payer: Cigna of CA HMO |
$76.34
|
| Rate for Payer: Cigna of CA PPO |
$76.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$92.70
|
| Rate for Payer: Dignity Health Media |
$92.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$92.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.62
|
| Rate for Payer: Galaxy Health WC |
$92.70
|
| Rate for Payer: Global Benefits Group Commercial |
$65.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.15
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$81.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.81
|
| Rate for Payer: Multiplan Commercial |
$81.80
|
| Rate for Payer: Networks By Design Commercial |
$54.53
|
| Rate for Payer: Prime Health Services Commercial |
$92.70
|
| Rate for Payer: Riverside University Health System MISP |
$43.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$54.53
|
| Rate for Payer: United Healthcare All Other HMO |
$54.53
|
| Rate for Payer: United Healthcare HMO Rider |
$54.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$92.70
|
| Rate for Payer: Vantage Medical Group Senior |
$92.70
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
IP
|
$100.85
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$90.76 |
| Rate for Payer: Blue Shield of California EPN |
$53.85
|
| Rate for Payer: Cash Price |
$45.38
|
| Rate for Payer: Central Health Plan Commercial |
$80.68
|
| Rate for Payer: Cigna of CA HMO |
$70.60
|
| Rate for Payer: Cigna of CA PPO |
$70.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.34
|
| Rate for Payer: Galaxy Health WC |
$85.72
|
| Rate for Payer: Global Benefits Group Commercial |
$60.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$75.64
|
| Rate for Payer: Prime Health Services Commercial |
$85.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.08
|
| Rate for Payer: United Healthcare All Other HMO |
$37.19
|
| Rate for Payer: United Healthcare HMO Rider |
$36.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.28
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
OP
|
$100.85
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$90.76 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$55.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.17
|
| Rate for Payer: Blue Distinction Transplant |
$60.51
|
| Rate for Payer: Blue Shield of California Commercial |
$75.64
|
| Rate for Payer: Blue Shield of California EPN |
$54.86
|
| Rate for Payer: Cash Price |
$45.38
|
| Rate for Payer: Central Health Plan Commercial |
$80.68
|
| Rate for Payer: Cigna of CA HMO |
$70.60
|
| Rate for Payer: Cigna of CA PPO |
$70.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.72
|
| Rate for Payer: Dignity Health Media |
$85.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.34
|
| Rate for Payer: Galaxy Health WC |
$85.72
|
| Rate for Payer: Global Benefits Group Commercial |
$60.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$75.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$75.64
|
| Rate for Payer: Networks By Design Commercial |
$50.42
|
| Rate for Payer: Prime Health Services Commercial |
$85.72
|
| Rate for Payer: Riverside University Health System MISP |
$40.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.42
|
| Rate for Payer: United Healthcare All Other HMO |
$50.42
|
| Rate for Payer: United Healthcare HMO Rider |
$50.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.72
|
| Rate for Payer: Vantage Medical Group Senior |
$85.72
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
OP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$87.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.52
|
| Rate for Payer: Blue Distinction Transplant |
$58.42
|
| Rate for Payer: Blue Shield of California Commercial |
$61.24
|
| Rate for Payer: Blue Shield of California EPN |
$47.61
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Central Health Plan Commercial |
$77.89
|
| Rate for Payer: Cigna of CA HMO |
$62.31
|
| Rate for Payer: Cigna of CA PPO |
$72.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.76
|
| Rate for Payer: Dignity Health Media |
$82.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$73.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.47
|
| Rate for Payer: Multiplan Commercial |
$73.02
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
| Rate for Payer: Riverside University Health System MISP |
$38.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.68
|
| Rate for Payer: United Healthcare All Other HMO |
$48.68
|
| Rate for Payer: United Healthcare HMO Rider |
$48.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.76
|
| Rate for Payer: Vantage Medical Group Senior |
$82.76
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
IP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$87.62 |
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Central Health Plan Commercial |
$77.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.47
|
| Rate for Payer: Multiplan Commercial |
$73.02
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
OP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.35
|
| Rate for Payer: Blue Distinction Transplant |
$57.23
|
| Rate for Payer: Blue Shield of California Commercial |
$59.99
|
| Rate for Payer: Blue Shield of California EPN |
$46.64
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Media |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Riverside University Health System MISP |
$38.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
IP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
IP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$95.76 |
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: Central Health Plan Commercial |
$85.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.28
|
| Rate for Payer: Multiplan Commercial |
$79.80
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
OP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$95.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.86
|
| Rate for Payer: Blue Distinction Transplant |
$63.84
|
| Rate for Payer: Blue Shield of California Commercial |
$66.93
|
| Rate for Payer: Blue Shield of California EPN |
$52.03
|
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: Central Health Plan Commercial |
$85.12
|
| Rate for Payer: Cigna of CA HMO |
$68.10
|
| Rate for Payer: Cigna of CA PPO |
$78.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.44
|
| Rate for Payer: Dignity Health Media |
$90.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$79.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.28
|
| Rate for Payer: Multiplan Commercial |
$79.80
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
| Rate for Payer: Riverside University Health System MISP |
$42.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.20
|
| Rate for Payer: United Healthcare All Other HMO |
$53.20
|
| Rate for Payer: United Healthcare HMO Rider |
$53.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.44
|
| Rate for Payer: Vantage Medical Group Senior |
$90.44
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$127.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.07
|
| Rate for Payer: Blue Distinction Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$132.09
|
| Rate for Payer: Blue Shield of California EPN |
$102.69
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Media |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$157.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Riverside University Health System MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.00
|
| Rate for Payer: United Healthcare All Other HMO |
$105.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
IP
|
$89.15
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.83 |
| Max. Negotiated Rate |
$80.24 |
| Rate for Payer: Cash Price |
$40.12
|
| Rate for Payer: Central Health Plan Commercial |
$71.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.66
|
| Rate for Payer: Galaxy Health WC |
$75.78
|
| Rate for Payer: Global Benefits Group Commercial |
$53.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.83
|
| Rate for Payer: Multiplan Commercial |
$66.86
|
| Rate for Payer: Networks By Design Commercial |
$57.95
|
| Rate for Payer: Prime Health Services Commercial |
$75.78
|
|
|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
OP
|
$89.15
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.83 |
| Max. Negotiated Rate |
$80.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.67
|
| Rate for Payer: Blue Distinction Transplant |
$53.49
|
| Rate for Payer: Blue Shield of California Commercial |
$56.08
|
| Rate for Payer: Blue Shield of California EPN |
$43.59
|
| Rate for Payer: Cash Price |
$40.12
|
| Rate for Payer: Central Health Plan Commercial |
$71.32
|
| Rate for Payer: Cigna of CA HMO |
$57.06
|
| Rate for Payer: Cigna of CA PPO |
$65.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.78
|
| Rate for Payer: Dignity Health Media |
$75.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.66
|
| Rate for Payer: Galaxy Health WC |
$75.78
|
| Rate for Payer: Global Benefits Group Commercial |
$53.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.24
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$66.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.83
|
| Rate for Payer: Multiplan Commercial |
$66.86
|
| Rate for Payer: Networks By Design Commercial |
$57.95
|
| Rate for Payer: Prime Health Services Commercial |
$75.78
|
| Rate for Payer: Riverside University Health System MISP |
$35.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.58
|
| Rate for Payer: United Healthcare All Other HMO |
$44.58
|
| Rate for Payer: United Healthcare HMO Rider |
$44.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.78
|
| Rate for Payer: Vantage Medical Group Senior |
$75.78
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
IP
|
$89.15
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.83 |
| Max. Negotiated Rate |
$80.24 |
| Rate for Payer: Cash Price |
$40.12
|
| Rate for Payer: Central Health Plan Commercial |
$71.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.66
|
| Rate for Payer: Galaxy Health WC |
$75.78
|
| Rate for Payer: Global Benefits Group Commercial |
$53.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.83
|
| Rate for Payer: Multiplan Commercial |
$66.86
|
| Rate for Payer: Networks By Design Commercial |
$57.95
|
| Rate for Payer: Prime Health Services Commercial |
$75.78
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
OP
|
$89.15
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.83 |
| Max. Negotiated Rate |
$80.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.67
|
| Rate for Payer: Blue Distinction Transplant |
$53.49
|
| Rate for Payer: Blue Shield of California Commercial |
$56.08
|
| Rate for Payer: Blue Shield of California EPN |
$43.59
|
| Rate for Payer: Cash Price |
$40.12
|
| Rate for Payer: Central Health Plan Commercial |
$71.32
|
| Rate for Payer: Cigna of CA HMO |
$57.06
|
| Rate for Payer: Cigna of CA PPO |
$65.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.78
|
| Rate for Payer: Dignity Health Media |
$75.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.66
|
| Rate for Payer: Galaxy Health WC |
$75.78
|
| Rate for Payer: Global Benefits Group Commercial |
$53.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.24
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$66.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.83
|
| Rate for Payer: Multiplan Commercial |
$66.86
|
| Rate for Payer: Networks By Design Commercial |
$57.95
|
| Rate for Payer: Prime Health Services Commercial |
$75.78
|
| Rate for Payer: Riverside University Health System MISP |
$35.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.58
|
| Rate for Payer: United Healthcare All Other HMO |
$44.58
|
| Rate for Payer: United Healthcare HMO Rider |
$44.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.78
|
| Rate for Payer: Vantage Medical Group Senior |
$75.78
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
IP
|
$43.79
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$39.41 |
| Rate for Payer: Cash Price |
$19.71
|
| Rate for Payer: Central Health Plan Commercial |
$35.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.52
|
| Rate for Payer: Galaxy Health WC |
$37.22
|
| Rate for Payer: Global Benefits Group Commercial |
$26.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.76
|
| Rate for Payer: Multiplan Commercial |
$32.84
|
| Rate for Payer: Networks By Design Commercial |
$28.46
|
| Rate for Payer: Prime Health Services Commercial |
$37.22
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
OP
|
$43.79
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$39.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.87
|
| Rate for Payer: Blue Distinction Transplant |
$26.27
|
| Rate for Payer: Blue Shield of California Commercial |
$27.54
|
| Rate for Payer: Blue Shield of California EPN |
$21.41
|
| Rate for Payer: Cash Price |
$19.71
|
| Rate for Payer: Central Health Plan Commercial |
$35.03
|
| Rate for Payer: Cigna of CA HMO |
$28.03
|
| Rate for Payer: Cigna of CA PPO |
$32.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.22
|
| Rate for Payer: Dignity Health Media |
$37.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.52
|
| Rate for Payer: Galaxy Health WC |
$37.22
|
| Rate for Payer: Global Benefits Group Commercial |
$26.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.41
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$32.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.76
|
| Rate for Payer: Multiplan Commercial |
$32.84
|
| Rate for Payer: Networks By Design Commercial |
$28.46
|
| Rate for Payer: Prime Health Services Commercial |
$37.22
|
| Rate for Payer: Riverside University Health System MISP |
$17.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.90
|
| Rate for Payer: United Healthcare All Other HMO |
$21.90
|
| Rate for Payer: United Healthcare HMO Rider |
$21.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.22
|
| Rate for Payer: Vantage Medical Group Senior |
$37.22
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
OP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$232.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$192.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$235.19
|
| Rate for Payer: Blue Distinction Transplant |
$253.34
|
| Rate for Payer: Blue Shield of California Commercial |
$316.68
|
| Rate for Payer: Blue Shield of California EPN |
$229.70
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$358.90
|
| Rate for Payer: Dignity Health Media |
$358.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$316.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$147.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: Riverside University Health System MISP |
$168.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.12
|
| Rate for Payer: United Healthcare All Other HMO |
$211.12
|
| Rate for Payer: United Healthcare HMO Rider |
$211.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.90
|
| Rate for Payer: Vantage Medical Group Senior |
$358.90
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
IP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$380.02 |
| Rate for Payer: Blue Shield of California EPN |
$225.48
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Central Health Plan Commercial |
$337.79
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$380.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.45
|
| Rate for Payer: Multiplan Commercial |
$316.68
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.44
|
| Rate for Payer: United Healthcare All Other HMO |
$155.72
|
| Rate for Payer: United Healthcare HMO Rider |
$152.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$139.34
|
|
|
HC CATH UMBILICAL VESSEL 5.0FR
|
Facility
|
IP
|
$206.22
|
|
| Hospital Charge Code |
901603823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.24 |
| Max. Negotiated Rate |
$185.60 |
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Central Health Plan Commercial |
$164.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.49
|
| Rate for Payer: Galaxy Health WC |
$175.29
|
| Rate for Payer: Global Benefits Group Commercial |
$123.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$185.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$137.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.24
|
| Rate for Payer: Multiplan Commercial |
$154.66
|
| Rate for Payer: Networks By Design Commercial |
$134.04
|
| Rate for Payer: Prime Health Services Commercial |
$175.29
|
|
