|
HC KIT, ADULT CENTRAL LINE DRES CHANGE
|
Facility
IP
|
$194.81
|
|
| Hospital Charge Code |
901607207
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.96 |
| Max. Negotiated Rate |
$175.33 |
| Rate for Payer: Cash Price |
$87.66
|
| Rate for Payer: Central Health Plan Commercial |
$155.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.92
|
| Rate for Payer: Galaxy Health WC |
$165.59
|
| Rate for Payer: Global Benefits Group Commercial |
$116.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$175.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.96
|
| Rate for Payer: Multiplan Commercial |
$146.11
|
| Rate for Payer: Networks By Design Commercial |
$126.63
|
| Rate for Payer: Prime Health Services Commercial |
$165.59
|
|
|
HC KIT, ARTERIAL LINE DRSNG CHNG
|
Facility
OP
|
$85.27
|
|
| Hospital Charge Code |
901607861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.38
|
| Rate for Payer: BCBS Transplant Transplant |
$51.16
|
| Rate for Payer: Blue Shield of California Commercial |
$53.63
|
| Rate for Payer: Blue Shield of California EPN |
$41.70
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: Cigna of CA HMO |
$54.57
|
| Rate for Payer: Cigna of CA PPO |
$63.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.95
|
| Rate for Payer: IEHP medi-cal |
$29.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$55.43
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: Riverside University Health MISP |
$34.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.64
|
| Rate for Payer: United Healthcare All Other HMO |
$42.64
|
| Rate for Payer: United Healthcare HMO Rider |
$42.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC KIT, ARTERIAL LINE DRSNG CHNG
|
Facility
IP
|
$85.27
|
|
| Hospital Charge Code |
901607861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$76.74 |
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Central Health Plan Commercial |
$68.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.05
|
| Rate for Payer: Multiplan Commercial |
$63.95
|
| Rate for Payer: Networks By Design Commercial |
$55.43
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
|
|
HC KIT CATH CNTRL VNS 2.5FR
|
Facility
OP
|
$269.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$229.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$148.42
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$148.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.31
|
| Rate for Payer: BCBS Transplant Transplant |
$161.91
|
| Rate for Payer: Blue Shield of California Commercial |
$202.39
|
| Rate for Payer: Blue Shield of California EPN |
$146.80
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Central Health Plan Commercial |
$215.88
|
| Rate for Payer: Cigna of CA HMO |
$188.90
|
| Rate for Payer: Cigna of CA PPO |
$188.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$107.94
|
| Rate for Payer: Galaxy Health WC |
$229.37
|
| Rate for Payer: Global Benefits Group Commercial |
$161.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.86
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$202.39
|
| Rate for Payer: IEHP medi-cal |
$94.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.97
|
| Rate for Payer: Multiplan Commercial |
$202.39
|
| Rate for Payer: Networks By Design Commercial |
$134.92
|
| Rate for Payer: Prime Health Services Commercial |
$229.37
|
| Rate for Payer: Riverside University Health MISP |
$107.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.92
|
| Rate for Payer: United Healthcare All Other HMO |
$134.92
|
| Rate for Payer: United Healthcare HMO Rider |
$134.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.37
|
| Rate for Payer: Vantage Medical Group Senior |
$229.37
|
|
|
HC KIT CATH CNTRL VNS 2.5FR
|
Facility
IP
|
$269.85
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$242.86 |
| Rate for Payer: Blue Shield of California EPN |
$144.10
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Central Health Plan Commercial |
$215.88
|
| Rate for Payer: Cigna of CA HMO |
$188.90
|
| Rate for Payer: Cigna of CA PPO |
$188.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$107.94
|
| Rate for Payer: Galaxy Health WC |
$229.37
|
| Rate for Payer: Global Benefits Group Commercial |
$161.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.97
|
| Rate for Payer: Multiplan Commercial |
$202.39
|
| Rate for Payer: Prime Health Services Commercial |
$229.37
|
|
|
HC KIT CATH CNTRL VNS 3FR SL
|
Facility
IP
|
$265.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$238.90 |
| Rate for Payer: Cash Price |
$119.45
|
| Rate for Payer: Central Health Plan Commercial |
$212.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.18
|
| Rate for Payer: Galaxy Health WC |
$225.62
|
| Rate for Payer: Global Benefits Group Commercial |
$159.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.09
|
| Rate for Payer: Multiplan Commercial |
$199.08
|
| Rate for Payer: Networks By Design Commercial |
$172.54
|
| Rate for Payer: Prime Health Services Commercial |
$225.62
|
|
|
HC KIT CATH CNTRL VNS 3FR SL
|
Facility
OP
|
$265.44
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604826
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$225.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$145.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$145.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.82
|
| Rate for Payer: BCBS Transplant Transplant |
$159.26
|
| Rate for Payer: Blue Shield of California Commercial |
$166.96
|
| Rate for Payer: Blue Shield of California EPN |
$129.80
|
| Rate for Payer: Cash Price |
$119.45
|
| Rate for Payer: Cash Price |
$119.45
|
| Rate for Payer: Central Health Plan Commercial |
$212.35
|
| Rate for Payer: Cigna of CA HMO |
$169.88
|
| Rate for Payer: Cigna of CA PPO |
$196.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.18
|
| Rate for Payer: Galaxy Health WC |
$225.62
|
| Rate for Payer: Global Benefits Group Commercial |
$159.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$199.08
|
| Rate for Payer: IEHP medi-cal |
$92.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.09
|
| Rate for Payer: Multiplan Commercial |
$199.08
|
| Rate for Payer: Networks By Design Commercial |
$172.54
|
| Rate for Payer: Prime Health Services Commercial |
$225.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$159.26
|
| Rate for Payer: Riverside University Health MISP |
$106.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.72
|
| Rate for Payer: United Healthcare All Other HMO |
$132.72
|
| Rate for Payer: United Healthcare HMO Rider |
$132.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.62
|
| Rate for Payer: Vantage Medical Group Senior |
$225.62
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
IP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$731.00 |
| Rate for Payer: Blue Shield of California EPN |
$433.73
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
OP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$690.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$446.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$446.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$370.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$452.41
|
| Rate for Payer: BCBS Transplant Transplant |
$487.33
|
| Rate for Payer: Blue Shield of California Commercial |
$609.16
|
| Rate for Payer: Blue Shield of California EPN |
$441.85
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$690.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$609.16
|
| Rate for Payer: IEHP medi-cal |
$284.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Networks By Design Commercial |
$406.11
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
| Rate for Payer: Riverside University Health MISP |
$324.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$406.11
|
| Rate for Payer: United Healthcare All Other HMO |
$406.11
|
| Rate for Payer: United Healthcare HMO Rider |
$406.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$406.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$690.39
|
| Rate for Payer: Vantage Medical Group Senior |
$690.39
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
OP
|
$794.56
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.91 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$675.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$437.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$437.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$362.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$442.57
|
| Rate for Payer: BCBS Transplant Transplant |
$476.74
|
| Rate for Payer: Blue Shield of California Commercial |
$595.92
|
| Rate for Payer: Blue Shield of California EPN |
$432.24
|
| Rate for Payer: Cash Price |
$357.55
|
| Rate for Payer: Cash Price |
$357.55
|
| Rate for Payer: Central Health Plan Commercial |
$635.65
|
| Rate for Payer: Cigna of CA HMO |
$556.19
|
| Rate for Payer: Cigna of CA PPO |
$556.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$675.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$317.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$317.82
|
| Rate for Payer: Galaxy Health WC |
$675.38
|
| Rate for Payer: Global Benefits Group Commercial |
$476.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$715.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$595.92
|
| Rate for Payer: IEHP medi-cal |
$278.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$529.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.91
|
| Rate for Payer: Multiplan Commercial |
$595.92
|
| Rate for Payer: Networks By Design Commercial |
$397.28
|
| Rate for Payer: Prime Health Services Commercial |
$675.38
|
| Rate for Payer: Riverside University Health MISP |
$317.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$476.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$476.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$397.28
|
| Rate for Payer: United Healthcare All Other HMO |
$397.28
|
| Rate for Payer: United Healthcare HMO Rider |
$397.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$397.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$675.38
|
| Rate for Payer: Vantage Medical Group Senior |
$675.38
|
|
|
HC KIT CATH CNTRL VNS 4FR DL
|
Facility
IP
|
$794.56
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.91 |
| Max. Negotiated Rate |
$715.10 |
| Rate for Payer: Blue Shield of California EPN |
$424.30
|
| Rate for Payer: Cash Price |
$357.55
|
| Rate for Payer: Central Health Plan Commercial |
$635.65
|
| Rate for Payer: Cigna of CA HMO |
$556.19
|
| Rate for Payer: Cigna of CA PPO |
$556.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$317.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$317.82
|
| Rate for Payer: Galaxy Health WC |
$675.38
|
| Rate for Payer: Global Benefits Group Commercial |
$476.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$715.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$529.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.91
|
| Rate for Payer: Multiplan Commercial |
$595.92
|
| Rate for Payer: Prime Health Services Commercial |
$675.38
|
|
|
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: Blue Shield of California EPN |
$385.58
|
| 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 Transplant |
$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: LLUH Dept of Risk Management WC |
$144.41
|
| Rate for Payer: Multiplan Commercial |
$541.54
|
| Rate for Payer: Prime Health Services Commercial |
$613.75
|
|
|
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 |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$613.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$397.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$397.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$329.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$402.19
|
| Rate for Payer: BCBS Transplant Transplant |
$433.24
|
| Rate for Payer: Blue Shield of California Commercial |
$541.54
|
| Rate for Payer: Blue Shield of California EPN |
$392.80
|
| Rate for Payer: Cash Price |
$324.93
|
| 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: EPIC Health Plan Commercial |
$288.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$541.54
|
| Rate for Payer: IEHP medi-cal |
$252.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.61
|
| 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: Riverside University Health 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 |
$361.03
|
| Rate for Payer: United Healthcare All Other HMO |
$361.03
|
| Rate for Payer: United Healthcare HMO Rider |
$361.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.03
|
| 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 TL
|
Facility
OP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$690.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$446.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$446.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$370.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$452.41
|
| Rate for Payer: BCBS Transplant Transplant |
$487.33
|
| Rate for Payer: Blue Shield of California Commercial |
$609.16
|
| Rate for Payer: Blue Shield of California EPN |
$441.85
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$690.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$609.16
|
| Rate for Payer: IEHP medi-cal |
$284.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Networks By Design Commercial |
$406.11
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
| Rate for Payer: Riverside University Health MISP |
$324.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$406.11
|
| Rate for Payer: United Healthcare All Other HMO |
$406.11
|
| Rate for Payer: United Healthcare HMO Rider |
$406.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$406.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$690.39
|
| Rate for Payer: Vantage Medical Group Senior |
$690.39
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
IP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$731.00 |
| Rate for Payer: Blue Shield of California EPN |
$433.73
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
IP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$731.00 |
| Rate for Payer: Blue Shield of California EPN |
$433.73
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
OP
|
$812.22
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$690.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$446.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$446.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$370.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$452.41
|
| Rate for Payer: BCBS Transplant Transplant |
$487.33
|
| Rate for Payer: Blue Shield of California Commercial |
$609.16
|
| Rate for Payer: Blue Shield of California EPN |
$441.85
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Cash Price |
$365.50
|
| Rate for Payer: Central Health Plan Commercial |
$649.78
|
| Rate for Payer: Cigna of CA HMO |
$568.55
|
| Rate for Payer: Cigna of CA PPO |
$568.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$690.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$324.89
|
| Rate for Payer: Galaxy Health WC |
$690.39
|
| Rate for Payer: Global Benefits Group Commercial |
$487.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$609.16
|
| Rate for Payer: IEHP medi-cal |
$284.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.44
|
| Rate for Payer: Multiplan Commercial |
$609.16
|
| Rate for Payer: Networks By Design Commercial |
$406.11
|
| Rate for Payer: Prime Health Services Commercial |
$690.39
|
| Rate for Payer: Riverside University Health MISP |
$324.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$406.11
|
| Rate for Payer: United Healthcare All Other HMO |
$406.11
|
| Rate for Payer: United Healthcare HMO Rider |
$406.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$406.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$690.39
|
| Rate for Payer: Vantage Medical Group Senior |
$690.39
|
|
|
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: 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: 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: 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 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: Aetna of CA HMO/PPO |
$9.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.54
|
| Rate for Payer: BCBS Transplant Transplant |
$9.69
|
| Rate for Payer: Blue Shield of California Commercial |
$10.16
|
| Rate for Payer: Blue Shield of California EPN |
$7.90
|
| 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: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$12.11
|
| Rate for Payer: IEHP medi-cal |
$5.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.69
|
| Rate for Payer: Riverside University Health 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 |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO |
$8.08
|
| Rate for Payer: United Healthcare HMO Rider |
$8.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Blue Shield of California EPN |
$374.57
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$385.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$390.71
|
| Rate for Payer: BCBS Transplant Transplant |
$420.87
|
| Rate for Payer: Blue Shield of California Commercial |
$526.09
|
| Rate for Payer: Blue Shield of California EPN |
$381.59
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$526.09
|
| Rate for Payer: IEHP medi-cal |
$245.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| 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 |
$350.72
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health 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 |
$350.72
|
| Rate for Payer: United Healthcare All Other HMO |
$350.72
|
| Rate for Payer: United Healthcare HMO Rider |
$350.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$350.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Blue Shield of California EPN |
$374.57
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$385.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$390.71
|
| Rate for Payer: BCBS Transplant Transplant |
$420.87
|
| Rate for Payer: Blue Shield of California Commercial |
$526.09
|
| Rate for Payer: Blue Shield of California EPN |
$381.59
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$526.09
|
| Rate for Payer: IEHP medi-cal |
$245.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| 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 |
$350.72
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health 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 |
$350.72
|
| Rate for Payer: United Healthcare All Other HMO |
$350.72
|
| Rate for Payer: United Healthcare HMO Rider |
$350.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$350.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Blue Shield of California EPN |
$374.57
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$385.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$390.71
|
| Rate for Payer: BCBS Transplant Transplant |
$420.87
|
| Rate for Payer: Blue Shield of California Commercial |
$526.09
|
| Rate for Payer: Blue Shield of California EPN |
$381.59
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.02
|
| Rate for Payer: Cigna of CA PPO |
$491.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$526.09
|
| Rate for Payer: IEHP medi-cal |
$245.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| 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 |
$350.72
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health 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 |
$350.72
|
| Rate for Payer: United Healthcare All Other HMO |
$350.72
|
| Rate for Payer: United Healthcare HMO Rider |
$350.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$350.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
