|
HC KIT CATH INTRAAORTIC 8FR 40CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901605380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC KIT CATH INTRAAORTIC 8FR 40CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901605380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,268.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,472.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC KIT CATH MAHURKAR 11.5FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH MAHURKAR 11.5FR
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CATH NEONATAL 5FR PVP
|
Facility
|
OP
|
$16.48
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$37.37 |
| Rate for Payer: Adventist Health Commercial |
$3.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.59
|
| Rate for Payer: Blue Shield of California Commercial |
$10.45
|
| Rate for Payer: Blue Shield of California EPN |
$6.58
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Central Health Plan Commercial |
$13.18
|
| Rate for Payer: Cigna of CA HMO |
$10.55
|
| Rate for Payer: Cigna of CA PPO |
$12.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.54
|
| Rate for Payer: Multiplan Commercial |
$12.36
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
| Rate for Payer: Riverside University Health System MISP |
$6.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.24
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.01
|
| Rate for Payer: Vantage Medical Group Senior |
$14.01
|
|
|
HC KIT CATH NEONATAL 5FR PVP
|
Facility
|
IP
|
$16.48
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$14.83 |
| Rate for Payer: Adventist Health Commercial |
$3.30
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Central Health Plan Commercial |
$13.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.30
|
| Rate for Payer: Multiplan Commercial |
$12.36
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
|
|
HC KIT, CATH PACING 5FR W/INTRO
|
Facility
|
IP
|
$204.89
|
|
| Hospital Charge Code |
901607989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.98 |
| Max. Negotiated Rate |
$184.40 |
| Rate for Payer: Adventist Health Commercial |
$40.98
|
| Rate for Payer: Cash Price |
$92.20
|
| Rate for Payer: Central Health Plan Commercial |
$163.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$143.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.96
|
| Rate for Payer: EPIC Health Plan Senior |
$81.96
|
| Rate for Payer: Galaxy Health WC |
$174.16
|
| Rate for Payer: Global Benefits Group Commercial |
$122.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$184.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$130.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$120.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.98
|
| Rate for Payer: Multiplan Commercial |
$153.67
|
| Rate for Payer: Networks By Design Commercial |
$133.18
|
| Rate for Payer: Prime Health Services Commercial |
$174.16
|
|
|
HC KIT, CATH PACING 5FR W/INTRO
|
Facility
|
OP
|
$204.89
|
|
| Hospital Charge Code |
901607989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.98 |
| Max. Negotiated Rate |
$184.40 |
| Rate for Payer: Adventist Health Commercial |
$40.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$174.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$112.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$153.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.18
|
| Rate for Payer: Blue Shield of California Commercial |
$129.90
|
| Rate for Payer: Blue Shield of California EPN |
$81.75
|
| Rate for Payer: Cash Price |
$92.20
|
| Rate for Payer: Central Health Plan Commercial |
$163.91
|
| Rate for Payer: Cigna of CA HMO |
$131.13
|
| Rate for Payer: Cigna of CA PPO |
$151.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$174.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$174.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$174.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$143.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.96
|
| Rate for Payer: EPIC Health Plan Senior |
$81.96
|
| Rate for Payer: Galaxy Health WC |
$174.16
|
| Rate for Payer: Global Benefits Group Commercial |
$122.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$184.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$130.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$74.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$120.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$143.42
|
| Rate for Payer: Multiplan Commercial |
$153.67
|
| Rate for Payer: Networks By Design Commercial |
$133.18
|
| Rate for Payer: Prime Health Services Commercial |
$174.16
|
| Rate for Payer: Riverside University Health System MISP |
$81.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$122.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$122.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$102.44
|
| Rate for Payer: United Healthcare All Other HMO |
$102.44
|
| Rate for Payer: United Healthcare HMO Rider |
$102.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$102.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$174.16
|
| Rate for Payer: Vantage Medical Group Senior |
$174.16
|
|
|
HC KIT CATH PEDIATRIC 8FR PVP
|
Facility
|
IP
|
$15.42
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$13.88 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Central Health Plan Commercial |
$12.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Senior |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$13.11
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.11
|
|
|
HC KIT CATH PEDIATRIC 8FR PVP
|
Facility
|
OP
|
$15.42
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$37.37 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.97
|
| Rate for Payer: Blue Shield of California Commercial |
$9.78
|
| Rate for Payer: Blue Shield of California EPN |
$6.15
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Central Health Plan Commercial |
$12.34
|
| Rate for Payer: Cigna of CA HMO |
$9.87
|
| Rate for Payer: Cigna of CA PPO |
$11.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Senior |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$13.11
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.79
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.11
|
| Rate for Payer: Riverside University Health System MISP |
$6.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.71
|
| Rate for Payer: United Healthcare All Other HMO |
$7.71
|
| Rate for Payer: United Healthcare HMO Rider |
$7.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.11
|
| Rate for Payer: Vantage Medical Group Senior |
$13.11
|
|
|
HC KIT CATH U-BND 2LUM 12FRX16CM
|
Facility
|
OP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$623.44 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$519.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$379.88
|
| Rate for Payer: Blue Shield of California Commercial |
$555.55
|
| Rate for Payer: Blue Shield of California EPN |
$349.13
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Central Health Plan Commercial |
$554.17
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$588.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$588.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$484.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.08
|
| Rate for Payer: EPIC Health Plan Senior |
$277.08
|
| Rate for Payer: Galaxy Health WC |
$588.80
|
| Rate for Payer: Global Benefits Group Commercial |
$415.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$251.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$484.90
|
| Rate for Payer: Multiplan Commercial |
$519.53
|
| Rate for Payer: Networks By Design Commercial |
$346.36
|
| Rate for Payer: Prime Health Services Commercial |
$588.80
|
| Rate for Payer: Riverside University Health System MISP |
$277.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.97
|
| Rate for Payer: United Healthcare All Other HMO |
$253.05
|
| Rate for Payer: United Healthcare HMO Rider |
$247.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$588.80
|
| Rate for Payer: Vantage Medical Group Senior |
$588.80
|
|
|
HC KIT CATH U-BND 2LUM 12FRX16CM
|
Facility
|
IP
|
$692.71
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.54 |
| Max. Negotiated Rate |
$623.44 |
| Rate for Payer: Adventist Health Commercial |
$138.54
|
| Rate for Payer: Blue Shield of California Commercial |
$555.55
|
| Rate for Payer: Blue Shield of California EPN |
$349.13
|
| Rate for Payer: Cash Price |
$311.72
|
| Rate for Payer: Central Health Plan Commercial |
$554.17
|
| Rate for Payer: Cigna of CA HMO |
$484.90
|
| Rate for Payer: Cigna of CA PPO |
$484.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$484.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.08
|
| Rate for Payer: EPIC Health Plan Senior |
$277.08
|
| Rate for Payer: Galaxy Health WC |
$588.80
|
| Rate for Payer: Global Benefits Group Commercial |
$415.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$439.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.54
|
| Rate for Payer: Multiplan Commercial |
$519.53
|
| Rate for Payer: Networks By Design Commercial |
$346.36
|
| Rate for Payer: Prime Health Services Commercial |
$588.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.97
|
| Rate for Payer: United Healthcare All Other HMO |
$253.05
|
| Rate for Payer: United Healthcare HMO Rider |
$247.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.86
|
|
|
HC KIT CATH U-BND 2LUM 12FRX20CM
|
Facility
|
OP
|
$655.04
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.01 |
| Max. Negotiated Rate |
$589.54 |
| Rate for Payer: Adventist Health Commercial |
$131.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$556.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$360.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$491.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$299.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$359.22
|
| Rate for Payer: Blue Shield of California Commercial |
$525.34
|
| Rate for Payer: Blue Shield of California EPN |
$330.14
|
| Rate for Payer: Cash Price |
$294.77
|
| Rate for Payer: Central Health Plan Commercial |
$524.03
|
| Rate for Payer: Cigna of CA HMO |
$458.53
|
| Rate for Payer: Cigna of CA PPO |
$458.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$556.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$556.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$556.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$458.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.02
|
| Rate for Payer: EPIC Health Plan Senior |
$262.02
|
| Rate for Payer: Galaxy Health WC |
$556.78
|
| Rate for Payer: Global Benefits Group Commercial |
$393.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$589.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$415.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$458.53
|
| Rate for Payer: Multiplan Commercial |
$491.28
|
| Rate for Payer: Networks By Design Commercial |
$327.52
|
| Rate for Payer: Prime Health Services Commercial |
$556.78
|
| Rate for Payer: Riverside University Health System MISP |
$262.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$393.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$393.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$245.84
|
| Rate for Payer: United Healthcare All Other HMO |
$239.29
|
| Rate for Payer: United Healthcare HMO Rider |
$234.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$556.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$556.78
|
| Rate for Payer: Vantage Medical Group Senior |
$556.78
|
|
|
HC KIT CATH U-BND 2LUM 12FRX20CM
|
Facility
|
IP
|
$655.04
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.01 |
| Max. Negotiated Rate |
$589.54 |
| Rate for Payer: Adventist Health Commercial |
$131.01
|
| Rate for Payer: Blue Shield of California Commercial |
$525.34
|
| Rate for Payer: Blue Shield of California EPN |
$330.14
|
| Rate for Payer: Cash Price |
$294.77
|
| Rate for Payer: Central Health Plan Commercial |
$524.03
|
| Rate for Payer: Cigna of CA HMO |
$458.53
|
| Rate for Payer: Cigna of CA PPO |
$458.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$458.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.02
|
| Rate for Payer: EPIC Health Plan Senior |
$262.02
|
| Rate for Payer: Galaxy Health WC |
$556.78
|
| Rate for Payer: Global Benefits Group Commercial |
$393.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$589.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$415.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.01
|
| Rate for Payer: Multiplan Commercial |
$491.28
|
| Rate for Payer: Networks By Design Commercial |
$327.52
|
| Rate for Payer: Prime Health Services Commercial |
$556.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$245.84
|
| Rate for Payer: United Healthcare All Other HMO |
$239.29
|
| Rate for Payer: United Healthcare HMO Rider |
$234.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.53
|
|
|
HC KIT CENTRAL VENOUS 4 LUMEN 8.5 FR,POWER INJ
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CENTRAL VENOUS 4 LUMEN 8.5 FR,POWER INJ
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
OP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$552.02 |
| Rate for Payer: Adventist Health Commercial |
$122.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$521.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$460.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$336.37
|
| Rate for Payer: Blue Shield of California Commercial |
$491.91
|
| Rate for Payer: Blue Shield of California EPN |
$309.13
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Central Health Plan Commercial |
$490.69
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$521.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$521.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$521.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Senior |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$552.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$222.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$429.35
|
| Rate for Payer: Multiplan Commercial |
$460.02
|
| Rate for Payer: Networks By Design Commercial |
$306.68
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: Riverside University Health System MISP |
$245.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$368.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$368.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.19
|
| Rate for Payer: United Healthcare All Other HMO |
$224.06
|
| Rate for Payer: United Healthcare HMO Rider |
$219.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$521.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$521.36
|
| Rate for Payer: Vantage Medical Group Senior |
$521.36
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
IP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$552.02 |
| Rate for Payer: Adventist Health Commercial |
$122.67
|
| Rate for Payer: Blue Shield of California Commercial |
$491.91
|
| Rate for Payer: Blue Shield of California EPN |
$309.13
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Central Health Plan Commercial |
$490.69
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$429.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Senior |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$552.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$389.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.67
|
| Rate for Payer: Multiplan Commercial |
$460.02
|
| Rate for Payer: Networks By Design Commercial |
$306.68
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.19
|
| Rate for Payer: United Healthcare All Other HMO |
$224.06
|
| Rate for Payer: United Healthcare HMO Rider |
$219.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.88
|
|
|
HC KIT CNTRL LINE CHANGE INFANT
|
Facility
|
OP
|
$96.84
|
|
| Hospital Charge Code |
901698193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.37 |
| Max. Negotiated Rate |
$87.16 |
| Rate for Payer: Adventist Health Commercial |
$19.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.33
|
| Rate for Payer: Blue Shield of California Commercial |
$61.40
|
| Rate for Payer: Blue Shield of California EPN |
$38.64
|
| Rate for Payer: Cash Price |
$43.58
|
| Rate for Payer: Central Health Plan Commercial |
$77.47
|
| Rate for Payer: Cigna of CA HMO |
$61.98
|
| Rate for Payer: Cigna of CA PPO |
$71.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.74
|
| Rate for Payer: EPIC Health Plan Senior |
$38.74
|
| Rate for Payer: Galaxy Health WC |
$82.31
|
| Rate for Payer: Global Benefits Group Commercial |
$58.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67.79
|
| Rate for Payer: Multiplan Commercial |
$72.63
|
| Rate for Payer: Networks By Design Commercial |
$62.95
|
| Rate for Payer: Prime Health Services Commercial |
$82.31
|
| Rate for Payer: Riverside University Health System MISP |
$38.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.42
|
| Rate for Payer: United Healthcare All Other HMO |
$48.42
|
| Rate for Payer: United Healthcare HMO Rider |
$48.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.31
|
| Rate for Payer: Vantage Medical Group Senior |
$82.31
|
|
|
HC KIT CNTRL LINE CHANGE INFANT
|
Facility
|
IP
|
$96.84
|
|
| Hospital Charge Code |
901698193
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.37 |
| Max. Negotiated Rate |
$87.16 |
| Rate for Payer: Adventist Health Commercial |
$19.37
|
| Rate for Payer: Cash Price |
$43.58
|
| Rate for Payer: Central Health Plan Commercial |
$77.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.74
|
| Rate for Payer: EPIC Health Plan Senior |
$38.74
|
| Rate for Payer: Galaxy Health WC |
$82.31
|
| Rate for Payer: Global Benefits Group Commercial |
$58.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.37
|
| Rate for Payer: Multiplan Commercial |
$72.63
|
| Rate for Payer: Networks By Design Commercial |
$62.95
|
| Rate for Payer: Prime Health Services Commercial |
$82.31
|
|
|
HC KIT CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.85
|
| Rate for Payer: Blue Shield of California Commercial |
$25.99
|
| Rate for Payer: Blue Shield of California EPN |
$16.36
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Riverside University Health System MISP |
$16.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20.50
|
| Rate for Payer: United Healthcare HMO Rider |
$20.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34.85
|
|
|
HC KIT CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
IP
|
$153.72
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$138.35 |
| Rate for Payer: Adventist Health Commercial |
$30.74
|
| Rate for Payer: Cash Price |
$69.17
|
| Rate for Payer: Central Health Plan Commercial |
$122.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.49
|
| Rate for Payer: EPIC Health Plan Senior |
$61.49
|
| Rate for Payer: Galaxy Health WC |
$130.66
|
| Rate for Payer: Global Benefits Group Commercial |
$92.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.74
|
| Rate for Payer: Multiplan Commercial |
$115.29
|
| Rate for Payer: Networks By Design Commercial |
$99.92
|
| Rate for Payer: Prime Health Services Commercial |
$130.66
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
OP
|
$153.72
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$138.35 |
| Rate for Payer: Adventist Health Commercial |
$30.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$130.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.42
|
| Rate for Payer: Blue Shield of California Commercial |
$97.46
|
| Rate for Payer: Blue Shield of California EPN |
$61.33
|
| Rate for Payer: Cash Price |
$69.17
|
| Rate for Payer: Cash Price |
$69.17
|
| Rate for Payer: Central Health Plan Commercial |
$122.98
|
| Rate for Payer: Cigna of CA HMO |
$98.38
|
| Rate for Payer: Cigna of CA PPO |
$113.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$130.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.49
|
| Rate for Payer: EPIC Health Plan Senior |
$61.49
|
| Rate for Payer: Galaxy Health WC |
$130.66
|
| Rate for Payer: Global Benefits Group Commercial |
$92.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$107.60
|
| Rate for Payer: Multiplan Commercial |
$115.29
|
| Rate for Payer: Networks By Design Commercial |
$99.92
|
| Rate for Payer: Prime Health Services Commercial |
$130.66
|
| Rate for Payer: Riverside University Health System MISP |
$61.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.86
|
| Rate for Payer: United Healthcare All Other HMO |
$76.86
|
| Rate for Payer: United Healthcare HMO Rider |
$76.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$130.66
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
IP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$252.19 |
| Rate for Payer: Adventist Health Commercial |
$56.04
|
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: Central Health Plan Commercial |
$224.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: EPIC Health Plan Senior |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$165.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.04
|
| Rate for Payer: Multiplan Commercial |
$210.16
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
|
