|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
|
OP
|
$839.59
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.92 |
| Max. Negotiated Rate |
$755.63 |
| Rate for Payer: Adventist Health Commercial |
$167.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$713.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$461.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$629.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$383.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$464.88
|
| Rate for Payer: Blue Shield of California Commercial |
$649.00
|
| Rate for Payer: Blue Shield of California EPN |
$423.15
|
| Rate for Payer: Cash Price |
$377.82
|
| Rate for Payer: Central Health Plan Commercial |
$671.67
|
| Rate for Payer: Cigna of CA HMO |
$587.71
|
| Rate for Payer: Cigna of CA PPO |
$587.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$713.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$713.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$713.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$335.84
|
| Rate for Payer: EPIC Health Plan Senior |
$335.84
|
| Rate for Payer: Galaxy Health WC |
$713.65
|
| Rate for Payer: Global Benefits Group Commercial |
$503.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$755.63
|
| Rate for Payer: InnovAge PACE Commercial |
$419.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$560.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$519.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$587.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$587.71
|
| Rate for Payer: Multiplan Commercial |
$629.69
|
| Rate for Payer: Networks By Design Commercial |
$419.80
|
| Rate for Payer: Prime Health Services Commercial |
$713.65
|
| Rate for Payer: Riverside University Health System MISP |
$335.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$503.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$503.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.10
|
| Rate for Payer: United Healthcare All Other HMO |
$306.70
|
| Rate for Payer: United Healthcare HMO Rider |
$300.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$274.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$713.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$713.65
|
| Rate for Payer: Vantage Medical Group Senior |
$713.65
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
|
IP
|
$849.30
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.86 |
| Max. Negotiated Rate |
$764.37 |
| Rate for Payer: Adventist Health Commercial |
$169.86
|
| Rate for Payer: Blue Shield of California Commercial |
$656.51
|
| Rate for Payer: Blue Shield of California EPN |
$428.05
|
| Rate for Payer: Cash Price |
$382.18
|
| Rate for Payer: Central Health Plan Commercial |
$679.44
|
| Rate for Payer: Cigna of CA HMO |
$594.51
|
| Rate for Payer: Cigna of CA PPO |
$594.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.72
|
| Rate for Payer: EPIC Health Plan Senior |
$339.72
|
| Rate for Payer: Galaxy Health WC |
$721.90
|
| Rate for Payer: Global Benefits Group Commercial |
$509.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$764.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$323.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$525.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.86
|
| Rate for Payer: Multiplan Commercial |
$636.98
|
| Rate for Payer: Networks By Design Commercial |
$424.65
|
| Rate for Payer: Prime Health Services Commercial |
$721.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.74
|
| Rate for Payer: United Healthcare All Other HMO |
$310.25
|
| Rate for Payer: United Healthcare HMO Rider |
$303.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.15
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
|
IP
|
$839.59
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.92 |
| Max. Negotiated Rate |
$755.63 |
| Rate for Payer: Adventist Health Commercial |
$167.92
|
| Rate for Payer: Blue Shield of California Commercial |
$649.00
|
| Rate for Payer: Blue Shield of California EPN |
$423.15
|
| Rate for Payer: Cash Price |
$377.82
|
| Rate for Payer: Central Health Plan Commercial |
$671.67
|
| Rate for Payer: Cigna of CA HMO |
$587.71
|
| Rate for Payer: Cigna of CA PPO |
$587.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$335.84
|
| Rate for Payer: EPIC Health Plan Senior |
$335.84
|
| Rate for Payer: Galaxy Health WC |
$713.65
|
| Rate for Payer: Global Benefits Group Commercial |
$503.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$755.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$560.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$519.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.92
|
| Rate for Payer: Multiplan Commercial |
$629.69
|
| Rate for Payer: Networks By Design Commercial |
$419.80
|
| Rate for Payer: Prime Health Services Commercial |
$713.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.10
|
| Rate for Payer: United Healthcare All Other HMO |
$306.70
|
| Rate for Payer: United Healthcare HMO Rider |
$300.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$274.97
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
|
OP
|
$849.30
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.86 |
| Max. Negotiated Rate |
$764.37 |
| Rate for Payer: Adventist Health Commercial |
$169.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$721.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$636.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$387.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$470.26
|
| Rate for Payer: Blue Shield of California Commercial |
$656.51
|
| Rate for Payer: Blue Shield of California EPN |
$428.05
|
| Rate for Payer: Cash Price |
$382.18
|
| Rate for Payer: Central Health Plan Commercial |
$679.44
|
| Rate for Payer: Cigna of CA HMO |
$594.51
|
| Rate for Payer: Cigna of CA PPO |
$594.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$721.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$721.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$721.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.72
|
| Rate for Payer: EPIC Health Plan Senior |
$339.72
|
| Rate for Payer: Galaxy Health WC |
$721.90
|
| Rate for Payer: Global Benefits Group Commercial |
$509.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$764.37
|
| Rate for Payer: InnovAge PACE Commercial |
$424.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$323.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$525.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$594.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$594.51
|
| Rate for Payer: Multiplan Commercial |
$636.98
|
| Rate for Payer: Networks By Design Commercial |
$424.65
|
| Rate for Payer: Prime Health Services Commercial |
$721.90
|
| Rate for Payer: Riverside University Health System MISP |
$339.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$509.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$509.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.74
|
| Rate for Payer: United Healthcare All Other HMO |
$310.25
|
| Rate for Payer: United Healthcare HMO Rider |
$303.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$721.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$721.90
|
| Rate for Payer: Vantage Medical Group Senior |
$721.90
|
|
|
HC KIT CATH CNTRL VNS 5FR DL
|
Facility
|
OP
|
$722.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$649.85 |
| Rate for Payer: Adventist Health Commercial |
$144.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$613.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$397.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$329.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$399.80
|
| Rate for Payer: Blue Shield of California Commercial |
$558.15
|
| Rate for Payer: Blue Shield of California EPN |
$363.92
|
| Rate for Payer: Cash Price |
$324.93
|
| Rate for Payer: Central Health Plan Commercial |
$577.65
|
| Rate for Payer: Cigna of CA HMO |
$505.44
|
| Rate for Payer: Cigna of CA PPO |
$505.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$613.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$613.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$613.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.82
|
| Rate for Payer: EPIC Health Plan Senior |
$288.82
|
| Rate for Payer: Galaxy Health WC |
$613.75
|
| Rate for Payer: Global Benefits Group Commercial |
$433.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.85
|
| Rate for Payer: InnovAge PACE Commercial |
$361.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$505.44
|
| Rate for Payer: Multiplan Commercial |
$541.54
|
| Rate for Payer: Networks By Design Commercial |
$361.03
|
| Rate for Payer: Prime Health Services Commercial |
$613.75
|
| Rate for Payer: Riverside University Health System MISP |
$288.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$270.99
|
| Rate for Payer: United Healthcare All Other HMO |
$263.77
|
| Rate for Payer: United Healthcare HMO Rider |
$258.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$236.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$613.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$613.75
|
| Rate for Payer: Vantage Medical Group Senior |
$613.75
|
|
|
HC KIT CATH CNTRL VNS 5FR DL
|
Facility
|
IP
|
$722.06
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$649.85 |
| Rate for Payer: Adventist Health Commercial |
$144.41
|
| Rate for Payer: Blue Shield of California Commercial |
$558.15
|
| Rate for Payer: Blue Shield of California EPN |
$363.92
|
| Rate for Payer: Cash Price |
$324.93
|
| Rate for Payer: Central Health Plan Commercial |
$577.65
|
| Rate for Payer: Cigna of CA HMO |
$505.44
|
| Rate for Payer: Cigna of CA PPO |
$505.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.82
|
| Rate for Payer: EPIC Health Plan Senior |
$288.82
|
| Rate for Payer: Galaxy Health WC |
$613.75
|
| Rate for Payer: Global Benefits Group Commercial |
$433.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.41
|
| Rate for Payer: Multiplan Commercial |
$541.54
|
| Rate for Payer: Networks By Design Commercial |
$361.03
|
| Rate for Payer: Prime Health Services Commercial |
$613.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$270.99
|
| Rate for Payer: United Healthcare All Other HMO |
$263.77
|
| Rate for Payer: United Healthcare HMO Rider |
$258.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$236.47
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$387.63
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$646.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$393.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.96
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$387.63
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$732.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$732.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$732.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: InnovAge PACE Commercial |
$430.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.98
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: Riverside University Health System MISP |
$344.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$732.19
|
| Rate for Payer: Vantage Medical Group Senior |
$732.19
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$646.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$393.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.96
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$387.63
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$732.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$732.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$732.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: InnovAge PACE Commercial |
$430.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.98
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: Riverside University Health System MISP |
$344.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$732.19
|
| Rate for Payer: Vantage Medical Group Senior |
$732.19
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$387.63
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
OP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.48
|
| Rate for Payer: Blue Shield of California Commercial |
$9.87
|
| Rate for Payer: Blue Shield of California EPN |
$6.44
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Central Health Plan Commercial |
$12.92
|
| Rate for Payer: Cigna of CA HMO |
$10.34
|
| Rate for Payer: Cigna of CA PPO |
$11.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: InnovAge PACE Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.30
|
| Rate for Payer: Multiplan Commercial |
$12.11
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
| Rate for Payer: Riverside University Health System MISP |
$6.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.07
|
| Rate for Payer: United Healthcare All Other HMO |
$8.07
|
| Rate for Payer: United Healthcare HMO Rider |
$8.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
IP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Central Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$12.11
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$310.98
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$388.39
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: InnovAge PACE Commercial |
$350.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health System MISP |
$280.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$388.39
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: InnovAge PACE Commercial |
$350.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health System MISP |
$280.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO NGRA 12FR 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
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 |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| 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: 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: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA 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 HEMO NGRA 12FR 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
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 |
$448.34
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| 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 HEMO NGRA DL 12FR20C
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605110
|
|
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 |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| 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: 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: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
