|
HC KIT CATH MAHURKAR 11.5FR
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901603769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: 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 |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| 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 Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| 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: 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: 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH NEONATAL 5FR PVP
|
Facility
|
IP
|
$16.48
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$14.83 |
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Central Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.30
|
| Rate for Payer: Multiplan Commercial |
$12.36
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
|
|
HC KIT CATH NEONATAL 5FR PVP
|
Facility
|
OP
|
$16.48
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$38.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.74
|
| Rate for Payer: Blue Distinction Transplant |
$9.89
|
| Rate for Payer: Blue Shield of California Commercial |
$10.37
|
| Rate for Payer: Blue Shield of California EPN |
$8.06
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Central Health Plan Commercial |
$13.18
|
| Rate for Payer: Cigna of CA HMO |
$10.55
|
| Rate for Payer: Cigna of CA PPO |
$12.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.01
|
| Rate for Payer: Dignity Health Media |
$14.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.83
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.30
|
| Rate for Payer: Multiplan Commercial |
$12.36
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
| Rate for Payer: Riverside University Health System MISP |
$6.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.24
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.01
|
| Rate for Payer: Vantage Medical Group Senior |
$14.01
|
|
|
HC KIT, CATH PACING 5FR W/INTRO
|
Facility
|
IP
|
$1,058.64
|
|
| Hospital Charge Code |
901607989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$211.73 |
| Max. Negotiated Rate |
$952.78 |
| Rate for Payer: Cash Price |
$476.39
|
| Rate for Payer: Central Health Plan Commercial |
$846.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.46
|
| Rate for Payer: Galaxy Health WC |
$899.84
|
| Rate for Payer: Global Benefits Group Commercial |
$635.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$952.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$706.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.73
|
| Rate for Payer: Multiplan Commercial |
$793.98
|
| Rate for Payer: Networks By Design Commercial |
$688.12
|
| Rate for Payer: Prime Health Services Commercial |
$899.84
|
|
|
HC KIT, CATH PACING 5FR W/INTRO
|
Facility
|
OP
|
$1,058.64
|
|
| Hospital Charge Code |
901607989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$211.73 |
| Max. Negotiated Rate |
$952.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$642.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$899.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$582.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$582.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$512.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$625.44
|
| Rate for Payer: Blue Distinction Transplant |
$635.18
|
| Rate for Payer: Blue Shield of California Commercial |
$665.88
|
| Rate for Payer: Blue Shield of California EPN |
$517.67
|
| Rate for Payer: Cash Price |
$476.39
|
| Rate for Payer: Central Health Plan Commercial |
$846.91
|
| Rate for Payer: Cigna of CA HMO |
$677.53
|
| Rate for Payer: Cigna of CA PPO |
$783.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$899.84
|
| Rate for Payer: Dignity Health Media |
$899.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$899.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$423.46
|
| Rate for Payer: Galaxy Health WC |
$899.84
|
| Rate for Payer: Global Benefits Group Commercial |
$635.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$952.78
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$793.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$370.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$706.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$403.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.73
|
| Rate for Payer: Multiplan Commercial |
$793.98
|
| Rate for Payer: Networks By Design Commercial |
$688.12
|
| Rate for Payer: Prime Health Services Commercial |
$899.84
|
| Rate for Payer: Riverside University Health System MISP |
$423.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$635.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$635.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$529.32
|
| Rate for Payer: United Healthcare All Other HMO |
$529.32
|
| Rate for Payer: United Healthcare HMO Rider |
$529.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$529.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$899.84
|
| Rate for Payer: Vantage Medical Group Senior |
$899.84
|
|
|
HC KIT CATH PEDIATRIC 8FR PVP
|
Facility
|
OP
|
$14.92
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$38.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.81
|
| Rate for Payer: Blue Distinction Transplant |
$8.95
|
| Rate for Payer: Blue Shield of California Commercial |
$9.38
|
| Rate for Payer: Blue Shield of California EPN |
$7.30
|
| Rate for Payer: Cash Price |
$6.71
|
| Rate for Payer: Cash Price |
$6.71
|
| Rate for Payer: Central Health Plan Commercial |
$11.94
|
| Rate for Payer: Cigna of CA HMO |
$9.55
|
| Rate for Payer: Cigna of CA PPO |
$11.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.68
|
| Rate for Payer: Dignity Health Media |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.97
|
| Rate for Payer: Galaxy Health WC |
$12.68
|
| Rate for Payer: Global Benefits Group Commercial |
$8.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.43
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$11.19
|
| Rate for Payer: Networks By Design Commercial |
$9.70
|
| Rate for Payer: Prime Health Services Commercial |
$12.68
|
| Rate for Payer: Riverside University Health System MISP |
$5.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.46
|
| Rate for Payer: United Healthcare All Other HMO |
$7.46
|
| Rate for Payer: United Healthcare HMO Rider |
$7.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$12.68
|
|
|
HC KIT CATH PEDIATRIC 8FR PVP
|
Facility
|
IP
|
$14.92
|
|
|
Service Code
|
CPT A4311
|
| Hospital Charge Code |
901607342
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Cash Price |
$6.71
|
| Rate for Payer: Central Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.97
|
| Rate for Payer: Galaxy Health WC |
$12.68
|
| Rate for Payer: Global Benefits Group Commercial |
$8.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$11.19
|
| Rate for Payer: Networks By Design Commercial |
$9.70
|
| Rate for Payer: Prime Health Services Commercial |
$12.68
|
|
|
HC KIT CATH U-BND 2LUM 12FRX16CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698355
|
|
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: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| 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
|
| Rate for Payer: United Healthcare All Other Commercial |
$264.87
|
| Rate for Payer: United Healthcare All Other HMO |
$258.69
|
| Rate for Payer: United Healthcare HMO Rider |
$253.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$231.48
|
|
|
HC KIT CATH U-BND 2LUM 12FRX16CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| 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 |
$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: Blue Distinction 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: 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: Dignity Health Media |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$526.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$245.51
|
| 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: 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 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 |
$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 U-BND 2LUM 12FRX20CM
|
Facility
|
IP
|
$663.32
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.66 |
| Max. Negotiated Rate |
$596.99 |
| Rate for Payer: Blue Shield of California EPN |
$354.21
|
| Rate for Payer: Cash Price |
$298.49
|
| Rate for Payer: Central Health Plan Commercial |
$530.66
|
| Rate for Payer: Cigna of CA HMO |
$464.32
|
| Rate for Payer: Cigna of CA PPO |
$464.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$265.33
|
| Rate for Payer: Galaxy Health WC |
$563.82
|
| Rate for Payer: Global Benefits Group Commercial |
$397.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$596.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$442.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.66
|
| Rate for Payer: Multiplan Commercial |
$497.49
|
| Rate for Payer: Prime Health Services Commercial |
$563.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$250.47
|
| Rate for Payer: United Healthcare All Other HMO |
$244.63
|
| Rate for Payer: United Healthcare HMO Rider |
$239.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$218.90
|
|
|
HC KIT CATH U-BND 2LUM 12FRX20CM
|
Facility
|
OP
|
$663.32
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.66 |
| Max. Negotiated Rate |
$596.99 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$563.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$364.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$364.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$302.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.47
|
| Rate for Payer: Blue Distinction Transplant |
$397.99
|
| Rate for Payer: Blue Shield of California Commercial |
$497.49
|
| Rate for Payer: Blue Shield of California EPN |
$360.85
|
| Rate for Payer: Cash Price |
$298.49
|
| Rate for Payer: Central Health Plan Commercial |
$530.66
|
| Rate for Payer: Cigna of CA HMO |
$464.32
|
| Rate for Payer: Cigna of CA PPO |
$464.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$563.82
|
| Rate for Payer: Dignity Health Media |
$563.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$563.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$265.33
|
| Rate for Payer: Galaxy Health WC |
$563.82
|
| Rate for Payer: Global Benefits Group Commercial |
$397.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$596.99
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$497.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$232.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$442.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.66
|
| Rate for Payer: Multiplan Commercial |
$497.49
|
| Rate for Payer: Networks By Design Commercial |
$331.66
|
| Rate for Payer: Prime Health Services Commercial |
$563.82
|
| Rate for Payer: Riverside University Health System MISP |
$265.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$397.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$397.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$331.66
|
| Rate for Payer: United Healthcare All Other HMO |
$331.66
|
| Rate for Payer: United Healthcare HMO Rider |
$331.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$331.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$563.82
|
| Rate for Payer: Vantage Medical Group Senior |
$563.82
|
|
|
HC KIT CENTRAL VENOUS 4 LUMEN 8.5 FR,POWER INJ
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: 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 |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| 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 Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| 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: 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: 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CENTRAL VENOUS 4 LUMEN 8.5 FR,POWER INJ
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| 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 Transplant |
$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: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
OP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$552.02 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$521.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$341.64
|
| Rate for Payer: Blue Distinction Transplant |
$368.02
|
| Rate for Payer: Blue Shield of California Commercial |
$460.02
|
| Rate for Payer: Blue Shield of California EPN |
$333.67
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Central Health Plan Commercial |
$490.69
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$521.36
|
| Rate for Payer: Dignity Health Media |
$521.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$521.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$552.02
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$460.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$214.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$409.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.67
|
| Rate for Payer: Multiplan Commercial |
$460.02
|
| Rate for Payer: Networks By Design Commercial |
$306.68
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: Riverside University Health System MISP |
$245.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$368.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$368.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$306.68
|
| Rate for Payer: United Healthcare All Other HMO |
$306.68
|
| Rate for Payer: United Healthcare HMO Rider |
$306.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$306.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$521.36
|
| Rate for Payer: Vantage Medical Group Senior |
$521.36
|
|
|
HC KIT CENTRAL VENOUS CATHETER MAC 9FR DL W/CURVED SUTURE NEEDLE
|
Facility
|
IP
|
$613.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607200
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$552.02 |
| Rate for Payer: Blue Shield of California EPN |
$327.53
|
| Rate for Payer: Cash Price |
$276.01
|
| Rate for Payer: Central Health Plan Commercial |
$490.69
|
| Rate for Payer: Cigna of CA HMO |
$429.35
|
| Rate for Payer: Cigna of CA PPO |
$429.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$245.34
|
| Rate for Payer: Galaxy Health WC |
$521.36
|
| Rate for Payer: Global Benefits Group Commercial |
$368.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$552.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$409.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.67
|
| Rate for Payer: Multiplan Commercial |
$460.02
|
| Rate for Payer: Prime Health Services Commercial |
$521.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$231.60
|
| Rate for Payer: United Healthcare All Other HMO |
$226.21
|
| Rate for Payer: United Healthcare HMO Rider |
$221.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$202.41
|
|
|
HC KIT CNTRL LINE CHANGE INFANT
|
Facility
|
IP
|
$85.27
|
|
| Hospital Charge Code |
901698193
|
|
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: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| 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 CNTRL LINE CHANGE INFANT
|
Facility
|
OP
|
$85.27
|
|
| Hospital Charge Code |
901698193
|
|
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: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care 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: Blue Distinction 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: Dignity Health Media |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$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) Other |
$63.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| 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: Riverside University Health System 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 CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
IP
|
$39.85
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Central Health Plan Commercial |
$31.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.94
|
| Rate for Payer: Galaxy Health WC |
$33.87
|
| Rate for Payer: Global Benefits Group Commercial |
$23.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.97
|
| Rate for Payer: Multiplan Commercial |
$29.89
|
| Rate for Payer: Networks By Design Commercial |
$25.90
|
| Rate for Payer: Prime Health Services Commercial |
$33.87
|
|
|
HC KIT CVC/PICC DRSNG CHNG, ADULT
|
Facility
|
OP
|
$39.85
|
|
| Hospital Charge Code |
901698239
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.54
|
| Rate for Payer: Blue Distinction Transplant |
$23.91
|
| Rate for Payer: Blue Shield of California Commercial |
$25.07
|
| Rate for Payer: Blue Shield of California EPN |
$19.49
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Central Health Plan Commercial |
$31.88
|
| Rate for Payer: Cigna of CA HMO |
$25.50
|
| Rate for Payer: Cigna of CA PPO |
$29.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.87
|
| Rate for Payer: Dignity Health Media |
$33.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.94
|
| Rate for Payer: Galaxy Health WC |
$33.87
|
| Rate for Payer: Global Benefits Group Commercial |
$23.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.97
|
| Rate for Payer: Multiplan Commercial |
$29.89
|
| Rate for Payer: Networks By Design Commercial |
$25.90
|
| Rate for Payer: Prime Health Services Commercial |
$33.87
|
| Rate for Payer: Riverside University Health System MISP |
$15.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.92
|
| Rate for Payer: United Healthcare All Other HMO |
$19.92
|
| Rate for Payer: United Healthcare HMO Rider |
$19.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.87
|
| Rate for Payer: Vantage Medical Group Senior |
$33.87
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.80
|
| Rate for Payer: Blue Distinction Transplant |
$91.20
|
| Rate for Payer: Blue Shield of California Commercial |
$95.61
|
| Rate for Payer: Blue Shield of California EPN |
$74.33
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Media |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$114.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC KIT DRSNG ASPIRA
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT A6258
|
| Hospital Charge Code |
901606874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
OP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$252.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$170.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$238.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$154.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.55
|
| Rate for Payer: Blue Distinction Transplant |
$168.13
|
| Rate for Payer: Blue Shield of California Commercial |
$176.25
|
| Rate for Payer: Blue Shield of California EPN |
$137.02
|
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: Central Health Plan Commercial |
$224.17
|
| Rate for Payer: Cigna of CA HMO |
$179.33
|
| Rate for Payer: Cigna of CA PPO |
$207.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.18
|
| Rate for Payer: Dignity Health Media |
$238.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$238.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.19
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$210.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$98.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.04
|
| Rate for Payer: Multiplan Commercial |
$210.16
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
| Rate for Payer: Riverside University Health System MISP |
$112.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.10
|
| Rate for Payer: United Healthcare All Other HMO |
$140.10
|
| Rate for Payer: United Healthcare HMO Rider |
$140.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.18
|
| Rate for Payer: Vantage Medical Group Senior |
$238.18
|
|
|
HC KIT DRSNG CHANGE PICC CVC
|
Facility
|
IP
|
$280.21
|
|
| Hospital Charge Code |
901698163
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$252.19 |
| Rate for Payer: Cash Price |
$126.09
|
| Rate for Payer: Central Health Plan Commercial |
$224.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.08
|
| Rate for Payer: Galaxy Health WC |
$238.18
|
| Rate for Payer: Global Benefits Group Commercial |
$168.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.04
|
| Rate for Payer: Multiplan Commercial |
$210.16
|
| Rate for Payer: Networks By Design Commercial |
$182.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.18
|
|
|
HC KIT IAP MONITOR
|
Facility
|
IP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$458.68 |
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: Central Health Plan Commercial |
$407.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.93
|
| Rate for Payer: Multiplan Commercial |
$382.24
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
|
|
HC KIT IAP MONITOR
|
Facility
|
OP
|
$509.65
|
|
| Hospital Charge Code |
901605588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.93 |
| Max. Negotiated Rate |
$458.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$309.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$433.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$280.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.10
|
| Rate for Payer: Blue Distinction Transplant |
$305.79
|
| Rate for Payer: Blue Shield of California Commercial |
$320.57
|
| Rate for Payer: Blue Shield of California EPN |
$249.22
|
| Rate for Payer: Cash Price |
$229.34
|
| Rate for Payer: Central Health Plan Commercial |
$407.72
|
| Rate for Payer: Cigna of CA HMO |
$326.18
|
| Rate for Payer: Cigna of CA PPO |
$377.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$433.20
|
| Rate for Payer: Dignity Health Media |
$433.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$433.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$203.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$203.86
|
| Rate for Payer: Galaxy Health WC |
$433.20
|
| Rate for Payer: Global Benefits Group Commercial |
$305.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$458.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$382.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$178.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$339.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$194.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.93
|
| Rate for Payer: Multiplan Commercial |
$382.24
|
| Rate for Payer: Networks By Design Commercial |
$331.27
|
| Rate for Payer: Prime Health Services Commercial |
$433.20
|
| Rate for Payer: Riverside University Health System MISP |
$203.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$254.82
|
| Rate for Payer: United Healthcare All Other HMO |
$254.82
|
| Rate for Payer: United Healthcare HMO Rider |
$254.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$433.20
|
| Rate for Payer: Vantage Medical Group Senior |
$433.20
|
|
