|
HC BAG DRAINAGE 4L A/R TWR LL
|
Facility
|
IP
|
$25.34
|
|
| Hospital Charge Code |
901607520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$20.27
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
|
|
HC BAG DRAINAGE SUCTION SYSTEM
|
Facility
|
OP
|
$234.57
|
|
| Hospital Charge Code |
901698959
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.91 |
| Max. Negotiated Rate |
$199.38 |
| Rate for Payer: Adventist Health Commercial |
$46.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$199.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.52
|
| Rate for Payer: Cash Price |
$105.56
|
| Rate for Payer: Cigna of CA HMO |
$150.12
|
| Rate for Payer: Cigna of CA PPO |
$173.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$199.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.83
|
| Rate for Payer: EPIC Health Plan Senior |
$93.83
|
| Rate for Payer: Galaxy Health WC |
$199.38
|
| Rate for Payer: Global Benefits Group Commercial |
$140.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$148.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$85.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$164.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$164.20
|
| Rate for Payer: Multiplan Commercial |
$187.66
|
| Rate for Payer: Networks By Design Commercial |
$152.47
|
| Rate for Payer: Prime Health Services Commercial |
$199.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$140.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$140.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.28
|
| Rate for Payer: United Healthcare All Other HMO |
$117.28
|
| Rate for Payer: United Healthcare HMO Rider |
$117.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$199.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.38
|
| Rate for Payer: Vantage Medical Group Senior |
$199.38
|
|
|
HC BAG DRAINAGE SUCTION SYSTEM
|
Facility
|
IP
|
$234.57
|
|
| Hospital Charge Code |
901698959
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.91 |
| Max. Negotiated Rate |
$199.38 |
| Rate for Payer: Adventist Health Commercial |
$46.91
|
| Rate for Payer: Cash Price |
$105.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$164.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.83
|
| Rate for Payer: EPIC Health Plan Senior |
$93.83
|
| Rate for Payer: Galaxy Health WC |
$199.38
|
| Rate for Payer: Global Benefits Group Commercial |
$140.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$148.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$138.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.30
|
| Rate for Payer: Multiplan Commercial |
$187.66
|
| Rate for Payer: Networks By Design Commercial |
$152.47
|
| Rate for Payer: Prime Health Services Commercial |
$199.38
|
|
|
HC BAG DRAINAGE URESIL GRAVITY
|
Facility
|
OP
|
$69.00
|
|
| Hospital Charge Code |
909001098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Adventist Health Commercial |
$13.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.28
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Cigna of CA HMO |
$44.16
|
| Rate for Payer: Cigna of CA PPO |
$51.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.60
|
| Rate for Payer: EPIC Health Plan Senior |
$27.60
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.30
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.50
|
| Rate for Payer: United Healthcare All Other HMO |
$34.50
|
| Rate for Payer: United Healthcare HMO Rider |
$34.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.65
|
| Rate for Payer: Vantage Medical Group Senior |
$58.65
|
|
|
HC BAG DRAINAGE URESIL GRAVITY
|
Facility
|
IP
|
$69.00
|
|
| Hospital Charge Code |
909001098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Adventist Health Commercial |
$13.80
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$48.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.60
|
| Rate for Payer: EPIC Health Plan Senior |
$27.60
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.56
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
|
|
HC BAG DRAINAGE URESIL SUCTION
|
Facility
|
IP
|
$88.00
|
|
| Hospital Charge Code |
909002002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.12
|
| Rate for Payer: Multiplan Commercial |
$70.40
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
|
HC BAG DRAINAGE URESIL SUCTION
|
Facility
|
OP
|
$88.00
|
|
| Hospital Charge Code |
909002002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$74.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.47
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$74.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$74.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$70.40
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44.00
|
| Rate for Payer: United Healthcare HMO Rider |
$44.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$74.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.80
|
| Rate for Payer: Vantage Medical Group Senior |
$74.80
|
|
|
HC BAG DRAIN ANTI REFLX L/F 2000ML
|
Facility
|
IP
|
$19.76
|
|
| Hospital Charge Code |
901607521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$16.80 |
| Rate for Payer: Adventist Health Commercial |
$3.95
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.90
|
| Rate for Payer: EPIC Health Plan Senior |
$7.90
|
| Rate for Payer: Galaxy Health WC |
$16.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: Networks By Design Commercial |
$12.84
|
| Rate for Payer: Prime Health Services Commercial |
$16.80
|
|
|
HC BAG DRAIN ANTI REFLX L/F 2000ML
|
Facility
|
OP
|
$19.76
|
|
| Hospital Charge Code |
901607521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$16.80 |
| Rate for Payer: Adventist Health Commercial |
$3.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.68
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cigna of CA HMO |
$12.65
|
| Rate for Payer: Cigna of CA PPO |
$14.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.90
|
| Rate for Payer: EPIC Health Plan Senior |
$7.90
|
| Rate for Payer: Galaxy Health WC |
$16.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.83
|
| Rate for Payer: Multiplan Commercial |
$15.81
|
| Rate for Payer: Networks By Design Commercial |
$12.84
|
| Rate for Payer: Prime Health Services Commercial |
$16.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.88
|
| Rate for Payer: United Healthcare All Other HMO |
$9.88
|
| Rate for Payer: United Healthcare HMO Rider |
$9.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
|
|
HC BAG DRAIN INTEFRA LIMITORR
|
Facility
|
OP
|
$274.82
|
|
| Hospital Charge Code |
901605691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.96 |
| Max. Negotiated Rate |
$233.60 |
| Rate for Payer: Adventist Health Commercial |
$54.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$180.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$233.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$206.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.35
|
| Rate for Payer: Cash Price |
$123.67
|
| Rate for Payer: Cigna of CA HMO |
$175.88
|
| Rate for Payer: Cigna of CA PPO |
$203.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$233.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$233.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$233.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$192.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.93
|
| Rate for Payer: EPIC Health Plan Senior |
$109.93
|
| Rate for Payer: Galaxy Health WC |
$233.60
|
| Rate for Payer: Global Benefits Group Commercial |
$164.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$174.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$162.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$192.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$192.37
|
| Rate for Payer: Multiplan Commercial |
$219.86
|
| Rate for Payer: Networks By Design Commercial |
$178.63
|
| Rate for Payer: Prime Health Services Commercial |
$233.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$137.41
|
| Rate for Payer: United Healthcare All Other HMO |
$137.41
|
| Rate for Payer: United Healthcare HMO Rider |
$137.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$137.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$233.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$233.60
|
| Rate for Payer: Vantage Medical Group Senior |
$233.60
|
|
|
HC BAG DRAIN INTEFRA LIMITORR
|
Facility
|
IP
|
$274.82
|
|
| Hospital Charge Code |
901605691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.96 |
| Max. Negotiated Rate |
$233.60 |
| Rate for Payer: Adventist Health Commercial |
$54.96
|
| Rate for Payer: Cash Price |
$123.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$192.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.93
|
| Rate for Payer: EPIC Health Plan Senior |
$109.93
|
| Rate for Payer: Galaxy Health WC |
$233.60
|
| Rate for Payer: Global Benefits Group Commercial |
$164.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$174.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$162.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.96
|
| Rate for Payer: Multiplan Commercial |
$219.86
|
| Rate for Payer: Networks By Design Commercial |
$178.63
|
| Rate for Payer: Prime Health Services Commercial |
$233.60
|
|
|
HC BAG EMPTY DIALYSIS STERILE
|
Facility
|
OP
|
$53.30
|
|
| Hospital Charge Code |
901601957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$45.30 |
| Rate for Payer: United Healthcare HMO Rider |
$26.65
|
| Rate for Payer: Adventist Health Commercial |
$10.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.20
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cigna of CA HMO |
$34.11
|
| Rate for Payer: Cigna of CA PPO |
$39.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.32
|
| Rate for Payer: EPIC Health Plan Senior |
$21.32
|
| Rate for Payer: Galaxy Health WC |
$45.30
|
| Rate for Payer: Global Benefits Group Commercial |
$31.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.31
|
| Rate for Payer: Multiplan Commercial |
$42.64
|
| Rate for Payer: Networks By Design Commercial |
$34.65
|
| Rate for Payer: Prime Health Services Commercial |
$45.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.65
|
| Rate for Payer: United Healthcare All Other HMO |
$26.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.30
|
| Rate for Payer: Vantage Medical Group Senior |
$45.30
|
|
|
HC BAG EMPTY DIALYSIS STERILE
|
Facility
|
IP
|
$53.30
|
|
| Hospital Charge Code |
901601957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$45.30 |
| Rate for Payer: Adventist Health Commercial |
$10.66
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.32
|
| Rate for Payer: EPIC Health Plan Senior |
$21.32
|
| Rate for Payer: Galaxy Health WC |
$45.30
|
| Rate for Payer: Global Benefits Group Commercial |
$31.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.79
|
| Rate for Payer: Multiplan Commercial |
$42.64
|
| Rate for Payer: Networks By Design Commercial |
$34.65
|
| Rate for Payer: Prime Health Services Commercial |
$45.30
|
|
|
HC BAG FARRELL VALVE PEDIATRIC
|
Facility
|
IP
|
$61.42
|
|
| Hospital Charge Code |
901604602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$52.21 |
| Rate for Payer: Adventist Health Commercial |
$12.28
|
| Rate for Payer: Cash Price |
$27.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.57
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: Galaxy Health WC |
$52.21
|
| Rate for Payer: Global Benefits Group Commercial |
$36.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.74
|
| Rate for Payer: Multiplan Commercial |
$49.14
|
| Rate for Payer: Networks By Design Commercial |
$39.92
|
| Rate for Payer: Prime Health Services Commercial |
$52.21
|
|
|
HC BAG FARRELL VALVE PEDIATRIC
|
Facility
|
OP
|
$61.42
|
|
| Hospital Charge Code |
901604602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$52.21 |
| Rate for Payer: Adventist Health Commercial |
$12.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.41
|
| Rate for Payer: Cash Price |
$27.64
|
| Rate for Payer: Cigna of CA HMO |
$39.31
|
| Rate for Payer: Cigna of CA PPO |
$45.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.57
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: Galaxy Health WC |
$52.21
|
| Rate for Payer: Global Benefits Group Commercial |
$36.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.99
|
| Rate for Payer: Multiplan Commercial |
$49.14
|
| Rate for Payer: Networks By Design Commercial |
$39.92
|
| Rate for Payer: Prime Health Services Commercial |
$52.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.71
|
| Rate for Payer: United Healthcare All Other HMO |
$30.71
|
| Rate for Payer: United Healthcare HMO Rider |
$30.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.21
|
| Rate for Payer: Vantage Medical Group Senior |
$52.21
|
|
|
HC BAG FECAL COLLECT FLXSL
|
Facility
|
OP
|
$31.49
|
|
| Hospital Charge Code |
901605922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: Adventist Health Commercial |
$6.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.21
|
| Rate for Payer: Cash Price |
$14.17
|
| Rate for Payer: Cigna of CA HMO |
$20.15
|
| Rate for Payer: Cigna of CA PPO |
$23.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12.60
|
| Rate for Payer: Galaxy Health WC |
$26.77
|
| Rate for Payer: Global Benefits Group Commercial |
$18.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.04
|
| Rate for Payer: Multiplan Commercial |
$25.19
|
| Rate for Payer: Networks By Design Commercial |
$20.47
|
| Rate for Payer: Prime Health Services Commercial |
$26.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.74
|
| Rate for Payer: United Healthcare All Other HMO |
$15.74
|
| Rate for Payer: United Healthcare HMO Rider |
$15.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.77
|
| Rate for Payer: Vantage Medical Group Senior |
$26.77
|
|
|
HC BAG FECAL COLLECT FLXSL
|
Facility
|
IP
|
$31.49
|
|
| Hospital Charge Code |
901605922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: Adventist Health Commercial |
$6.30
|
| Rate for Payer: Cash Price |
$14.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12.60
|
| Rate for Payer: Galaxy Health WC |
$26.77
|
| Rate for Payer: Global Benefits Group Commercial |
$18.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.56
|
| Rate for Payer: Multiplan Commercial |
$25.19
|
| Rate for Payer: Networks By Design Commercial |
$20.47
|
| Rate for Payer: Prime Health Services Commercial |
$26.77
|
|
|
HC BAG FLEXISEAL COLLECTION
|
Facility
|
OP
|
$50.27
|
|
| Hospital Charge Code |
901698765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.26
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO |
$32.17
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Senior |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.19
|
| Rate for Payer: Multiplan Commercial |
$40.22
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.14
|
| Rate for Payer: United Healthcare All Other HMO |
$25.14
|
| Rate for Payer: United Healthcare HMO Rider |
$25.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.73
|
| Rate for Payer: Vantage Medical Group Senior |
$42.73
|
|
|
HC BAG FLEXISEAL COLLECTION
|
Facility
|
IP
|
$50.27
|
|
| Hospital Charge Code |
901698765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Senior |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.06
|
| Rate for Payer: Multiplan Commercial |
$40.22
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
|
|
HC BAG FLEXISEAL PRIVACY
|
Facility
|
IP
|
$30.34
|
|
| Hospital Charge Code |
901606802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC BAG FLEXISEAL PRIVACY
|
Facility
|
OP
|
$30.34
|
|
| Hospital Charge Code |
901606802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.47
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.24
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC BAG LEG URN DRAIN STRAP 600ML
|
Facility
|
OP
|
$11.23
|
|
| Hospital Charge Code |
901698967
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Adventist Health Commercial |
$2.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.21
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Cigna of CA HMO |
$7.19
|
| Rate for Payer: Cigna of CA PPO |
$8.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.49
|
| Rate for Payer: EPIC Health Plan Senior |
$4.49
|
| Rate for Payer: Galaxy Health WC |
$9.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.86
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.30
|
| Rate for Payer: Prime Health Services Commercial |
$9.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.62
|
| Rate for Payer: United Healthcare All Other HMO |
$5.62
|
| Rate for Payer: United Healthcare HMO Rider |
$5.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.55
|
| Rate for Payer: Vantage Medical Group Senior |
$9.55
|
|
|
HC BAG LEG URN DRAIN STRAP 600ML
|
Facility
|
IP
|
$11.23
|
|
| Hospital Charge Code |
901698967
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Adventist Health Commercial |
$2.25
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.49
|
| Rate for Payer: EPIC Health Plan Senior |
$4.49
|
| Rate for Payer: Galaxy Health WC |
$9.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.70
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.30
|
| Rate for Payer: Prime Health Services Commercial |
$9.55
|
|
|
HC BAG TRU-CLOSE 1000ML SUCTION
|
Facility
|
OP
|
$172.90
|
|
| Hospital Charge Code |
901604143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.58 |
| Max. Negotiated Rate |
$146.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$113.41
|
| Rate for Payer: Adventist Health Commercial |
$34.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$146.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.95
|
| Rate for Payer: Cash Price |
$77.81
|
| Rate for Payer: Cigna of CA HMO |
$110.66
|
| Rate for Payer: Cigna of CA PPO |
$127.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$146.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$146.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$146.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.16
|
| Rate for Payer: EPIC Health Plan Senior |
$69.16
|
| Rate for Payer: Galaxy Health WC |
$146.97
|
| Rate for Payer: Global Benefits Group Commercial |
$103.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$102.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.03
|
| Rate for Payer: Multiplan Commercial |
$138.32
|
| Rate for Payer: Networks By Design Commercial |
$112.39
|
| Rate for Payer: Prime Health Services Commercial |
$146.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$86.45
|
| Rate for Payer: United Healthcare All Other HMO |
$86.45
|
| Rate for Payer: United Healthcare HMO Rider |
$86.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$146.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$146.97
|
| Rate for Payer: Vantage Medical Group Senior |
$146.97
|
|
|
HC BAG TRU-CLOSE 1000ML SUCTION
|
Facility
|
IP
|
$172.90
|
|
| Hospital Charge Code |
901604143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.58 |
| Max. Negotiated Rate |
$146.97 |
| Rate for Payer: Adventist Health Commercial |
$34.58
|
| Rate for Payer: Cash Price |
$77.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.16
|
| Rate for Payer: EPIC Health Plan Senior |
$69.16
|
| Rate for Payer: Galaxy Health WC |
$146.97
|
| Rate for Payer: Global Benefits Group Commercial |
$103.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$102.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.50
|
| Rate for Payer: Multiplan Commercial |
$138.32
|
| Rate for Payer: Networks By Design Commercial |
$112.39
|
| Rate for Payer: Prime Health Services Commercial |
$146.97
|
|
