|
HC ARTHROGRAPH SHOULDER
|
Facility
|
OP
|
$2,468.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$85.16 |
| Max. Negotiated Rate |
$2,097.80 |
| Rate for Payer: Adventist Health Commercial |
$493.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,618.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$590.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1,510.42
|
| Rate for Payer: Blue Shield of California EPN |
$997.07
|
| Rate for Payer: Cash Price |
$1,110.60
|
| Rate for Payer: Cash Price |
$1,110.60
|
| Rate for Payer: Cigna of CA HMO |
$1,579.52
|
| Rate for Payer: Cigna of CA PPO |
$1,826.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,097.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,480.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$592.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$1,974.40
|
| Rate for Payer: Networks By Design Commercial |
$1,604.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,097.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,480.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,480.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
IP
|
$1,675.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$335.00 |
| Max. Negotiated Rate |
$1,423.75 |
| Rate for Payer: Adventist Health Commercial |
$335.00
|
| Rate for Payer: Cash Price |
$753.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.00
|
| Rate for Payer: EPIC Health Plan Senior |
$670.00
|
| Rate for Payer: Galaxy Health WC |
$1,423.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,117.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$638.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,036.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.00
|
| Rate for Payer: Multiplan Commercial |
$1,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,088.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.75
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
OP
|
$1,675.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$69.12 |
| Max. Negotiated Rate |
$1,423.75 |
| Rate for Payer: Adventist Health Commercial |
$335.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,098.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$443.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,025.10
|
| Rate for Payer: Blue Shield of California EPN |
$676.70
|
| Rate for Payer: Cash Price |
$753.75
|
| Rate for Payer: Cash Price |
$753.75
|
| Rate for Payer: Cigna of CA HMO |
$1,072.00
|
| Rate for Payer: Cigna of CA PPO |
$1,239.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$1,423.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$69.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,117.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$1,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,088.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,005.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,005.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
IP
|
$11,858.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,371.60 |
| Max. Negotiated Rate |
$10,079.30 |
| Rate for Payer: Adventist Health Commercial |
$2,371.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,751.20
|
| Rate for Payer: Blue Shield of California EPN |
$5,762.99
|
| Rate for Payer: Cash Price |
$5,336.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,743.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,743.20
|
| Rate for Payer: Galaxy Health WC |
$10,079.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,114.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,909.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,517.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,340.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,845.92
|
| Rate for Payer: Multiplan Commercial |
$9,486.40
|
| Rate for Payer: Networks By Design Commercial |
$7,707.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,079.30
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
OP
|
$11,858.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$10,079.30 |
| Rate for Payer: Adventist Health Commercial |
$2,371.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$5,336.10
|
| Rate for Payer: Cash Price |
$5,336.10
|
| Rate for Payer: Cash Price |
$5,336.10
|
| Rate for Payer: Cigna of CA HMO |
$7,589.12
|
| Rate for Payer: Cigna of CA PPO |
$8,774.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$10,079.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,114.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,909.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,845.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$9,486.40
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,707.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,079.30
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,114.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,929.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,929.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,929.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,929.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
IP
|
$47.72
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$40.56 |
| Rate for Payer: Adventist Health Commercial |
$9.54
|
| Rate for Payer: Cash Price |
$21.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.09
|
| Rate for Payer: EPIC Health Plan Senior |
$19.09
|
| Rate for Payer: Galaxy Health WC |
$40.56
|
| Rate for Payer: Global Benefits Group Commercial |
$28.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.45
|
| Rate for Payer: Multiplan Commercial |
$38.18
|
| Rate for Payer: Networks By Design Commercial |
$31.02
|
| Rate for Payer: Prime Health Services Commercial |
$40.56
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
OP
|
$47.72
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$40.56 |
| Rate for Payer: Adventist Health Commercial |
$9.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.30
|
| Rate for Payer: Cash Price |
$21.47
|
| Rate for Payer: Cigna of CA HMO |
$30.54
|
| Rate for Payer: Cigna of CA PPO |
$35.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.09
|
| Rate for Payer: EPIC Health Plan Senior |
$19.09
|
| Rate for Payer: Galaxy Health WC |
$40.56
|
| Rate for Payer: Global Benefits Group Commercial |
$28.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.40
|
| Rate for Payer: Multiplan Commercial |
$38.18
|
| Rate for Payer: Networks By Design Commercial |
$31.02
|
| Rate for Payer: Prime Health Services Commercial |
$40.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.86
|
| Rate for Payer: United Healthcare All Other HMO |
$23.86
|
| Rate for Payer: United Healthcare HMO Rider |
$23.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.56
|
| Rate for Payer: Vantage Medical Group Senior |
$40.56
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
IP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$12.89 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
OP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$12.89 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.32
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Cigna of CA HMO |
$9.71
|
| Rate for Payer: Cigna of CA PPO |
$11.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.62
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.41
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.41
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
OP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$31.71 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.91
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cigna of CA HMO |
$23.88
|
| Rate for Payer: Cigna of CA PPO |
$27.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.66
|
| Rate for Payer: United Healthcare All Other HMO |
$18.66
|
| Rate for Payer: United Healthcare HMO Rider |
$18.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
IP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$31.71 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.95
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.41
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.68
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Multiplan Commercial |
$11.15
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.56
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Cigna of CA HMO |
$8.92
|
| Rate for Payer: Cigna of CA PPO |
$10.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.76
|
| Rate for Payer: Multiplan Commercial |
$11.15
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.97
|
| Rate for Payer: United Healthcare All Other HMO |
$6.97
|
| Rate for Payer: United Healthcare HMO Rider |
$6.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
IP
|
$14.76
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Multiplan Commercial |
$11.81
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
OP
|
$14.76
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.06
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cigna of CA HMO |
$9.45
|
| Rate for Payer: Cigna of CA PPO |
$10.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$11.81
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.38
|
| Rate for Payer: United Healthcare All Other HMO |
$7.38
|
| Rate for Payer: United Healthcare HMO Rider |
$7.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.55
|
| Rate for Payer: Vantage Medical Group Senior |
$12.55
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
OP
|
$14.76
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.06
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cigna of CA HMO |
$9.45
|
| Rate for Payer: Cigna of CA PPO |
$10.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$11.81
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.38
|
| Rate for Payer: United Healthcare All Other HMO |
$7.38
|
| Rate for Payer: United Healthcare HMO Rider |
$7.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.55
|
| Rate for Payer: Vantage Medical Group Senior |
$12.55
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
IP
|
$14.76
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Multiplan Commercial |
$11.81
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
IP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$73.39 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.72
|
| Rate for Payer: Multiplan Commercial |
$69.07
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
OP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$73.39 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.02
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cigna of CA HMO |
$55.26
|
| Rate for Payer: Cigna of CA PPO |
$63.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.44
|
| Rate for Payer: Multiplan Commercial |
$69.07
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.17
|
| Rate for Payer: United Healthcare All Other HMO |
$43.17
|
| Rate for Payer: United Healthcare HMO Rider |
$43.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.39
|
| Rate for Payer: Vantage Medical Group Senior |
$73.39
|
|
