|
HC BNDR ABD 12" 3 PANEL 46-62"
|
Facility
|
IP
|
$113.39
|
|
| Hospital Charge Code |
901607299
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$22.68 |
| Max. Negotiated Rate |
$96.38 |
| Rate for Payer: Adventist Health Commercial |
$22.68
|
| Rate for Payer: Cash Price |
$51.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.36
|
| Rate for Payer: EPIC Health Plan Senior |
$45.36
|
| Rate for Payer: Galaxy Health WC |
$96.38
|
| Rate for Payer: Global Benefits Group Commercial |
$68.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.21
|
| Rate for Payer: Multiplan Commercial |
$90.71
|
| Rate for Payer: Networks By Design Commercial |
$73.70
|
| Rate for Payer: Prime Health Services Commercial |
$96.38
|
|
|
HC BNDR ABD 12" 4 PANEL 30-45"
|
Facility
|
OP
|
$97.66
|
|
| Hospital Charge Code |
901607296
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$19.53 |
| Max. Negotiated Rate |
$83.01 |
| Rate for Payer: Adventist Health Commercial |
$19.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.67
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cigna of CA HMO |
$62.50
|
| Rate for Payer: Cigna of CA PPO |
$72.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$83.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.06
|
| Rate for Payer: EPIC Health Plan Senior |
$39.06
|
| Rate for Payer: Galaxy Health WC |
$83.01
|
| Rate for Payer: Global Benefits Group Commercial |
$58.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.36
|
| Rate for Payer: Multiplan Commercial |
$78.13
|
| Rate for Payer: Networks By Design Commercial |
$63.48
|
| Rate for Payer: Prime Health Services Commercial |
$83.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.83
|
| Rate for Payer: United Healthcare All Other HMO |
$48.83
|
| Rate for Payer: United Healthcare HMO Rider |
$48.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$83.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.01
|
| Rate for Payer: Vantage Medical Group Senior |
$83.01
|
|
|
HC BNDR ABD 12" 4 PANEL 30-45"
|
Facility
|
IP
|
$97.66
|
|
| Hospital Charge Code |
901607296
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$19.53 |
| Max. Negotiated Rate |
$83.01 |
| Rate for Payer: Adventist Health Commercial |
$19.53
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.06
|
| Rate for Payer: EPIC Health Plan Senior |
$39.06
|
| Rate for Payer: Galaxy Health WC |
$83.01
|
| Rate for Payer: Global Benefits Group Commercial |
$58.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.44
|
| Rate for Payer: Multiplan Commercial |
$78.13
|
| Rate for Payer: Networks By Design Commercial |
$63.48
|
| Rate for Payer: Prime Health Services Commercial |
$83.01
|
|
|
HC BNDR ABD 12" 4 PANEL 45-62"
|
Facility
|
IP
|
$58.96
|
|
| Hospital Charge Code |
901698628
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$50.12 |
| Rate for Payer: Adventist Health Commercial |
$11.79
|
| Rate for Payer: Cash Price |
$26.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.58
|
| Rate for Payer: EPIC Health Plan Senior |
$23.58
|
| Rate for Payer: Galaxy Health WC |
$50.12
|
| Rate for Payer: Global Benefits Group Commercial |
$35.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.15
|
| Rate for Payer: Multiplan Commercial |
$47.17
|
| Rate for Payer: Networks By Design Commercial |
$38.32
|
| Rate for Payer: Prime Health Services Commercial |
$50.12
|
|
|
HC BNDR ABD 12" 4 PANEL 45-62"
|
Facility
|
OP
|
$58.96
|
|
| Hospital Charge Code |
901698628
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$50.12 |
| Rate for Payer: Adventist Health Commercial |
$11.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.83
|
| Rate for Payer: Cash Price |
$26.53
|
| Rate for Payer: Cigna of CA HMO |
$37.73
|
| Rate for Payer: Cigna of CA PPO |
$43.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.58
|
| Rate for Payer: EPIC Health Plan Senior |
$23.58
|
| Rate for Payer: Galaxy Health WC |
$50.12
|
| Rate for Payer: Global Benefits Group Commercial |
$35.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.27
|
| Rate for Payer: Multiplan Commercial |
$47.17
|
| Rate for Payer: Networks By Design Commercial |
$38.32
|
| Rate for Payer: Prime Health Services Commercial |
$50.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.48
|
| Rate for Payer: United Healthcare All Other HMO |
$29.48
|
| Rate for Payer: United Healthcare HMO Rider |
$29.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.12
|
| Rate for Payer: Vantage Medical Group Senior |
$50.12
|
|
|
HC BNDR ABD 12" 4 PANEL 46-62"
|
Facility
|
IP
|
$70.60
|
|
| Hospital Charge Code |
901607297
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$60.01 |
| Rate for Payer: Adventist Health Commercial |
$14.12
|
| Rate for Payer: Cash Price |
$31.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.24
|
| Rate for Payer: EPIC Health Plan Senior |
$28.24
|
| Rate for Payer: Galaxy Health WC |
$60.01
|
| Rate for Payer: Global Benefits Group Commercial |
$42.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.94
|
| Rate for Payer: Multiplan Commercial |
$56.48
|
| Rate for Payer: Networks By Design Commercial |
$45.89
|
| Rate for Payer: Prime Health Services Commercial |
$60.01
|
|
|
HC BNDR ABD 12" 4 PANEL 46-62"
|
Facility
|
OP
|
$70.60
|
|
| Hospital Charge Code |
901607297
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$60.01 |
| Rate for Payer: Adventist Health Commercial |
$14.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.30
|
| Rate for Payer: Cash Price |
$31.77
|
| Rate for Payer: Cigna of CA HMO |
$45.18
|
| Rate for Payer: Cigna of CA PPO |
$52.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$60.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.24
|
| Rate for Payer: EPIC Health Plan Senior |
$28.24
|
| Rate for Payer: Galaxy Health WC |
$60.01
|
| Rate for Payer: Global Benefits Group Commercial |
$42.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.42
|
| Rate for Payer: Multiplan Commercial |
$56.48
|
| Rate for Payer: Networks By Design Commercial |
$45.89
|
| Rate for Payer: Prime Health Services Commercial |
$60.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.30
|
| Rate for Payer: United Healthcare All Other HMO |
$35.30
|
| Rate for Payer: United Healthcare HMO Rider |
$35.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.01
|
| Rate for Payer: Vantage Medical Group Senior |
$60.01
|
|
|
HC BNDR ABD 12" MED-LRG 45-62"
|
Facility
|
IP
|
$59.94
|
|
| Hospital Charge Code |
901698627
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$50.95 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$26.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: EPIC Health Plan Senior |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.95
|
| Rate for Payer: Global Benefits Group Commercial |
$35.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$47.95
|
| Rate for Payer: Networks By Design Commercial |
$38.96
|
| Rate for Payer: Prime Health Services Commercial |
$50.95
|
|
|
HC BNDR ABD 12" MED-LRG 45-62"
|
Facility
|
OP
|
$59.94
|
|
| Hospital Charge Code |
901698627
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$50.95 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.46
|
| Rate for Payer: Cash Price |
$26.97
|
| Rate for Payer: Cigna of CA HMO |
$38.36
|
| Rate for Payer: Cigna of CA PPO |
$44.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: EPIC Health Plan Senior |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.95
|
| Rate for Payer: Global Benefits Group Commercial |
$35.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.96
|
| Rate for Payer: Multiplan Commercial |
$47.95
|
| Rate for Payer: Networks By Design Commercial |
$38.96
|
| Rate for Payer: Prime Health Services Commercial |
$50.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.97
|
| Rate for Payer: United Healthcare All Other HMO |
$29.97
|
| Rate for Payer: United Healthcare HMO Rider |
$29.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.95
|
| Rate for Payer: Vantage Medical Group Senior |
$50.95
|
|
|
HC BNDR,ABD 2XL 72-84" 3 PANEL
|
Facility
|
OP
|
$58.79
|
|
| Hospital Charge Code |
901605883
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$49.97 |
| Rate for Payer: Adventist Health Commercial |
$11.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.73
|
| Rate for Payer: Cash Price |
$26.46
|
| Rate for Payer: Cigna of CA HMO |
$37.63
|
| Rate for Payer: Cigna of CA PPO |
$43.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.52
|
| Rate for Payer: EPIC Health Plan Senior |
$23.52
|
| Rate for Payer: Galaxy Health WC |
$49.97
|
| Rate for Payer: Global Benefits Group Commercial |
$35.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.15
|
| Rate for Payer: Multiplan Commercial |
$47.03
|
| Rate for Payer: Networks By Design Commercial |
$38.21
|
| Rate for Payer: Prime Health Services Commercial |
$49.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.39
|
| Rate for Payer: United Healthcare All Other HMO |
$29.39
|
| Rate for Payer: United Healthcare HMO Rider |
$29.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.97
|
| Rate for Payer: Vantage Medical Group Senior |
$49.97
|
|
|
HC BNDR,ABD 2XL 72-84" 3 PANEL
|
Facility
|
IP
|
$58.79
|
|
| Hospital Charge Code |
901605883
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$49.97 |
| Rate for Payer: Adventist Health Commercial |
$11.76
|
| Rate for Payer: Cash Price |
$26.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.52
|
| Rate for Payer: EPIC Health Plan Senior |
$23.52
|
| Rate for Payer: Galaxy Health WC |
$49.97
|
| Rate for Payer: Global Benefits Group Commercial |
$35.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.11
|
| Rate for Payer: Multiplan Commercial |
$47.03
|
| Rate for Payer: Networks By Design Commercial |
$38.21
|
| Rate for Payer: Prime Health Services Commercial |
$49.97
|
|
|
HC BNDR ABD 2XL 72-84" 4 PANEL
|
Facility
|
OP
|
$62.98
|
|
| Hospital Charge Code |
901605884
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$53.53 |
| Rate for Payer: Adventist Health Commercial |
$12.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.41
|
| Rate for Payer: Cash Price |
$28.34
|
| Rate for Payer: Cigna of CA HMO |
$40.31
|
| Rate for Payer: Cigna of CA PPO |
$46.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.19
|
| Rate for Payer: EPIC Health Plan Senior |
$25.19
|
| Rate for Payer: Galaxy Health WC |
$53.53
|
| Rate for Payer: Global Benefits Group Commercial |
$37.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.09
|
| Rate for Payer: Multiplan Commercial |
$50.38
|
| Rate for Payer: Networks By Design Commercial |
$40.94
|
| Rate for Payer: Prime Health Services Commercial |
$53.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.49
|
| Rate for Payer: United Healthcare All Other HMO |
$31.49
|
| Rate for Payer: United Healthcare HMO Rider |
$31.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.53
|
| Rate for Payer: Vantage Medical Group Senior |
$53.53
|
|
|
HC BNDR ABD 2XL 72-84" 4 PANEL
|
Facility
|
IP
|
$62.98
|
|
| Hospital Charge Code |
901605884
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$53.53 |
| Rate for Payer: Adventist Health Commercial |
$12.60
|
| Rate for Payer: Cash Price |
$28.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.19
|
| Rate for Payer: EPIC Health Plan Senior |
$25.19
|
| Rate for Payer: Galaxy Health WC |
$53.53
|
| Rate for Payer: Global Benefits Group Commercial |
$37.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$50.38
|
| Rate for Payer: Networks By Design Commercial |
$40.94
|
| Rate for Payer: Prime Health Services Commercial |
$53.53
|
|
|
HC BNDR ABD 3XL 82-100" 4 PANEL
|
Facility
|
OP
|
$86.56
|
|
| Hospital Charge Code |
901692020
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$73.58 |
| Rate for Payer: Adventist Health Commercial |
$17.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.55
|
| Rate for Payer: Cash Price |
$38.95
|
| Rate for Payer: Cigna of CA HMO |
$55.40
|
| Rate for Payer: Cigna of CA PPO |
$64.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.62
|
| Rate for Payer: EPIC Health Plan Senior |
$34.62
|
| Rate for Payer: Galaxy Health WC |
$73.58
|
| Rate for Payer: Global Benefits Group Commercial |
$51.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.59
|
| Rate for Payer: Multiplan Commercial |
$69.25
|
| Rate for Payer: Networks By Design Commercial |
$56.26
|
| Rate for Payer: Prime Health Services Commercial |
$73.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.28
|
| Rate for Payer: United Healthcare All Other HMO |
$43.28
|
| Rate for Payer: United Healthcare HMO Rider |
$43.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.58
|
| Rate for Payer: Vantage Medical Group Senior |
$73.58
|
|
|
HC BNDR ABD 3XL 82-100" 4 PANEL
|
Facility
|
IP
|
$86.56
|
|
| Hospital Charge Code |
901692020
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$73.58 |
| Rate for Payer: Adventist Health Commercial |
$17.31
|
| Rate for Payer: Cash Price |
$38.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.62
|
| Rate for Payer: EPIC Health Plan Senior |
$34.62
|
| Rate for Payer: Galaxy Health WC |
$73.58
|
| Rate for Payer: Global Benefits Group Commercial |
$51.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.77
|
| Rate for Payer: Multiplan Commercial |
$69.25
|
| Rate for Payer: Networks By Design Commercial |
$56.26
|
| Rate for Payer: Prime Health Services Commercial |
$73.58
|
|
|
HC BNDR ABD 9" 3 PANEL 30-45"
|
Facility
|
OP
|
$50.10
|
|
| Hospital Charge Code |
901698686
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$42.59 |
| Rate for Payer: Adventist Health Commercial |
$10.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.15
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Cigna of CA HMO |
$32.06
|
| Rate for Payer: Cigna of CA PPO |
$37.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.04
|
| Rate for Payer: EPIC Health Plan Senior |
$20.04
|
| Rate for Payer: Galaxy Health WC |
$42.59
|
| Rate for Payer: Global Benefits Group Commercial |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.07
|
| Rate for Payer: Multiplan Commercial |
$40.08
|
| Rate for Payer: Networks By Design Commercial |
$32.56
|
| Rate for Payer: Prime Health Services Commercial |
$42.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.05
|
| Rate for Payer: United Healthcare All Other HMO |
$25.05
|
| Rate for Payer: United Healthcare HMO Rider |
$25.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.59
|
| Rate for Payer: Vantage Medical Group Senior |
$42.59
|
|
|
HC BNDR ABD 9" 3 PANEL 30-45"
|
Facility
|
IP
|
$50.10
|
|
| Hospital Charge Code |
901698686
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$42.59 |
| Rate for Payer: Adventist Health Commercial |
$10.02
|
| Rate for Payer: Cash Price |
$22.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.04
|
| Rate for Payer: EPIC Health Plan Senior |
$20.04
|
| Rate for Payer: Galaxy Health WC |
$42.59
|
| Rate for Payer: Global Benefits Group Commercial |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.02
|
| Rate for Payer: Multiplan Commercial |
$40.08
|
| Rate for Payer: Networks By Design Commercial |
$32.56
|
| Rate for Payer: Prime Health Services Commercial |
$42.59
|
|
|
HC BNDR ABD 9" 3PANEL 30-45" PROC
|
Facility
|
OP
|
$47.97
|
|
| Hospital Charge Code |
901698687
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Dignity Health Medi-Cal |
$40.77
|
| Rate for Payer: Adventist Health Commercial |
$9.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.78
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cigna of CA HMO |
$30.70
|
| Rate for Payer: Cigna of CA PPO |
$35.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.19
|
| Rate for Payer: EPIC Health Plan Senior |
$19.19
|
| Rate for Payer: Galaxy Health WC |
$40.77
|
| Rate for Payer: Global Benefits Group Commercial |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.58
|
| Rate for Payer: Multiplan Commercial |
$38.38
|
| Rate for Payer: Networks By Design Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$40.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.98
|
| Rate for Payer: United Healthcare All Other HMO |
$23.98
|
| Rate for Payer: United Healthcare HMO Rider |
$23.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.77
|
| Rate for Payer: Vantage Medical Group Senior |
$40.77
|
|
|
HC BNDR ABD 9" 3PANEL 30-45" PROC
|
Facility
|
IP
|
$47.97
|
|
| Hospital Charge Code |
901698687
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$40.77 |
| Rate for Payer: Adventist Health Commercial |
$9.59
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.19
|
| Rate for Payer: EPIC Health Plan Senior |
$19.19
|
| Rate for Payer: Galaxy Health WC |
$40.77
|
| Rate for Payer: Global Benefits Group Commercial |
$28.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Multiplan Commercial |
$38.38
|
| Rate for Payer: Networks By Design Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$40.77
|
|
|
HC BNDR ABD 9" 3PANEL 30-45"S/MED
|
Facility
|
OP
|
$86.26
|
|
| Hospital Charge Code |
901698688
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$73.32 |
| Rate for Payer: Adventist Health Commercial |
$17.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.35
|
| Rate for Payer: Cash Price |
$38.82
|
| Rate for Payer: Cigna of CA HMO |
$55.21
|
| Rate for Payer: Cigna of CA PPO |
$63.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.50
|
| Rate for Payer: EPIC Health Plan Senior |
$34.50
|
| Rate for Payer: Galaxy Health WC |
$73.32
|
| Rate for Payer: Global Benefits Group Commercial |
$51.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.38
|
| Rate for Payer: Multiplan Commercial |
$69.01
|
| Rate for Payer: Networks By Design Commercial |
$56.07
|
| Rate for Payer: Prime Health Services Commercial |
$73.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.13
|
| Rate for Payer: United Healthcare All Other HMO |
$43.13
|
| Rate for Payer: United Healthcare HMO Rider |
$43.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.32
|
| Rate for Payer: Vantage Medical Group Senior |
$73.32
|
|
|
HC BNDR ABD 9" 3PANEL 30-45"S/MED
|
Facility
|
IP
|
$86.26
|
|
| Hospital Charge Code |
901698688
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$73.32 |
| Rate for Payer: Adventist Health Commercial |
$17.25
|
| Rate for Payer: Cash Price |
$38.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.50
|
| Rate for Payer: EPIC Health Plan Senior |
$34.50
|
| Rate for Payer: Galaxy Health WC |
$73.32
|
| Rate for Payer: Global Benefits Group Commercial |
$51.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.70
|
| Rate for Payer: Multiplan Commercial |
$69.01
|
| Rate for Payer: Networks By Design Commercial |
$56.07
|
| Rate for Payer: Prime Health Services Commercial |
$73.32
|
|
|
HC BNDR ABD 9IN XL 75-84" 3 PANEL
|
Facility
|
IP
|
$105.26
|
|
| Hospital Charge Code |
901698833
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Adventist Health Commercial |
$21.05
|
| Rate for Payer: Cash Price |
$47.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.10
|
| Rate for Payer: EPIC Health Plan Senior |
$42.10
|
| Rate for Payer: Galaxy Health WC |
$89.47
|
| Rate for Payer: Global Benefits Group Commercial |
$63.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$62.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.26
|
| Rate for Payer: Multiplan Commercial |
$84.21
|
| Rate for Payer: Networks By Design Commercial |
$68.42
|
| Rate for Payer: Prime Health Services Commercial |
$89.47
|
|
|
HC BNDR ABD 9IN XL 75-84" 3 PANEL
|
Facility
|
OP
|
$105.26
|
|
| Hospital Charge Code |
901698833
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Vantage Medical Group Senior |
$89.47
|
| Rate for Payer: Adventist Health Commercial |
$21.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.55
|
| Rate for Payer: Cash Price |
$47.37
|
| Rate for Payer: Cigna of CA HMO |
$67.37
|
| Rate for Payer: Cigna of CA PPO |
$77.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.10
|
| Rate for Payer: EPIC Health Plan Senior |
$42.10
|
| Rate for Payer: Galaxy Health WC |
$89.47
|
| Rate for Payer: Global Benefits Group Commercial |
$63.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$62.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.68
|
| Rate for Payer: Multiplan Commercial |
$84.21
|
| Rate for Payer: Networks By Design Commercial |
$68.42
|
| Rate for Payer: Prime Health Services Commercial |
$89.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.63
|
| Rate for Payer: United Healthcare All Other HMO |
$52.63
|
| Rate for Payer: United Healthcare HMO Rider |
$52.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.47
|
|
|
HC BNDR ABD UNIV 9" WIDE 45-62"
|
Facility
|
IP
|
$42.72
|
|
| Hospital Charge Code |
901698644
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Multiplan Commercial |
$34.18
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
|
|
HC BNDR ABD UNIV 9" WIDE 45-62"
|
Facility
|
OP
|
$42.72
|
|
| Hospital Charge Code |
901698644
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.41
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cigna of CA HMO |
$27.34
|
| Rate for Payer: Cigna of CA PPO |
$31.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.90
|
| Rate for Payer: Multiplan Commercial |
$34.18
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.36
|
| Rate for Payer: United Healthcare All Other HMO |
$21.36
|
| Rate for Payer: United Healthcare HMO Rider |
$21.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Vantage Medical Group Senior |
$36.31
|
|
