|
HC CIPROFLOXACIN E TEST
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912443
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
|
HC CIRC ANTICOAG SCRN
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
900910015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$63.90 |
| 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 |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.90
|
| Rate for Payer: Blue Shield of California Commercial |
$46.16
|
| Rate for Payer: Blue Shield of California EPN |
$30.50
|
| Rate for Payer: Cash Price |
$31.05
|
| 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 |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Senior |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| 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 |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CIRC ANTICOAG SCRN
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
900910015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$146.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.64
|
| Rate for Payer: Multiplan Commercial |
$188.80
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC CISTERNOGRAM
|
Facility
|
IP
|
$2,882.00
|
|
|
Service Code
|
CPT 78630
|
| Hospital Charge Code |
909301413
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$576.40 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,152.80
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,098.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,783.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
|
|
HC CISTERNOGRAM
|
Facility
|
OP
|
$2,882.00
|
|
|
Service Code
|
CPT 78630
|
| Hospital Charge Code |
909301413
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$284.24 |
| Max. Negotiated Rate |
$2,449.70 |
| Rate for Payer: Adventist Health Commercial |
$576.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,890.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,769.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,763.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,164.33
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cash Price |
$1,296.90
|
| Rate for Payer: Cigna of CA HMO |
$1,844.48
|
| Rate for Payer: Cigna of CA PPO |
$2,132.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$923.31
|
| Rate for Payer: EPIC Health Plan Senior |
$683.93
|
| Rate for Payer: Galaxy Health WC |
$2,449.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,729.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,121.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$284.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$321.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$683.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$691.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$861.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$916.47
|
| Rate for Payer: Multiplan Commercial |
$2,305.60
|
| Rate for Payer: Networks By Design Commercial |
$1,873.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,449.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,729.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,729.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,570.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,570.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,570.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,570.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$683.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC CITRULLINATED PEPTIDE AB
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
900913554
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.49 |
| Max. Negotiated Rate |
$125.08 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.08
|
| Rate for Payer: Blue Shield of California Commercial |
$45.49
|
| Rate for Payer: Blue Shield of California EPN |
$30.06
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cigna of CA HMO |
$43.52
|
| Rate for Payer: Cigna of CA PPO |
$50.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$12.95
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$54.40
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
|
|
HC CITRULLINATED PEPTIDE AB
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
900913554
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: Adventist Health Commercial |
$24.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.60
|
| Rate for Payer: EPIC Health Plan Senior |
$49.60
|
| Rate for Payer: Galaxy Health WC |
$105.40
|
| Rate for Payer: Global Benefits Group Commercial |
$74.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.76
|
| Rate for Payer: Multiplan Commercial |
$99.20
|
| Rate for Payer: Networks By Design Commercial |
$80.60
|
| Rate for Payer: Prime Health Services Commercial |
$105.40
|
|
|
HC CK-MB
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
900910805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CK-MB
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
900910805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$114.04 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.04
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.59
|
| Rate for Payer: EPIC Health Plan Senior |
$11.55
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.48
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.36
|
| Rate for Payer: United Healthcare All Other HMO |
$9.36
|
| Rate for Payer: United Healthcare HMO Rider |
$9.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.36
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.71
|
| Rate for Payer: Vantage Medical Group Senior |
$11.55
|
|
|
HC CLAVICLE
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
909001478
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$440.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$408.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
|
|
HC CLAVICLE
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
909001478
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.91 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$432.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.49
|
| Rate for Payer: Blue Shield of California Commercial |
$403.92
|
| Rate for Payer: Blue Shield of California EPN |
$266.64
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cigna of CA HMO |
$422.40
|
| Rate for Payer: Cigna of CA PPO |
$488.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$440.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC CLAVICLE LARGE
|
Facility
|
OP
|
$37.31
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Adventist Health Commercial |
$15.30
|
| 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 |
$21.61
|
| Rate for Payer: Blue Shield of California Commercial |
$27.53
|
| Rate for Payer: Blue Shield of California EPN |
$18.13
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cigna of CA HMO |
$26.12
|
| Rate for Payer: Cigna of CA PPO |
$26.12
|
| 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: Inland Empire Health Plan (IEHP) Medi-Cal |
$60.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.36
|
| 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 |
$18.66
|
| 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 |
$14.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13.63
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.22
|
| 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 CLAVICLE LARGE
|
Facility
|
IP
|
$37.31
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cigna of CA HMO |
$26.12
|
| Rate for Payer: Cigna of CA PPO |
$26.12
|
| 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 |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13.63
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.22
|
|
|
HC CLEANSER FOAM NO RINSE
|
Facility
|
OP
|
$22.47
|
|
| Hospital Charge Code |
901698452
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Adventist Health Commercial |
$4.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.80
|
| Rate for Payer: Cash Price |
$10.11
|
| Rate for Payer: Cigna of CA HMO |
$14.38
|
| Rate for Payer: Cigna of CA PPO |
$16.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.99
|
| Rate for Payer: EPIC Health Plan Senior |
$8.99
|
| Rate for Payer: Galaxy Health WC |
$19.10
|
| Rate for Payer: Global Benefits Group Commercial |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$17.98
|
| Rate for Payer: Networks By Design Commercial |
$14.61
|
| Rate for Payer: Prime Health Services Commercial |
$19.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.23
|
| Rate for Payer: United Healthcare All Other HMO |
$11.23
|
| Rate for Payer: United Healthcare HMO Rider |
$11.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.10
|
| Rate for Payer: Vantage Medical Group Senior |
$19.10
|
|
|
HC CLEANSER FOAM NO RINSE
|
Facility
|
IP
|
$22.47
|
|
| Hospital Charge Code |
901698452
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Adventist Health Commercial |
$4.49
|
| Rate for Payer: Cash Price |
$10.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.99
|
| Rate for Payer: EPIC Health Plan Senior |
$8.99
|
| Rate for Payer: Galaxy Health WC |
$19.10
|
| Rate for Payer: Global Benefits Group Commercial |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$17.98
|
| Rate for Payer: Networks By Design Commercial |
$14.61
|
| Rate for Payer: Prime Health Services Commercial |
$19.10
|
|
|
HC CLEANSER, WOUND 6OZ SPRAY
|
Facility
|
IP
|
$55.51
|
|
|
Service Code
|
CPT A6260
|
| Hospital Charge Code |
901698238
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$47.18 |
| Rate for Payer: Adventist Health Commercial |
$11.10
|
| Rate for Payer: Cash Price |
$24.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.20
|
| Rate for Payer: EPIC Health Plan Senior |
$22.20
|
| Rate for Payer: Galaxy Health WC |
$47.18
|
| Rate for Payer: Global Benefits Group Commercial |
$33.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.32
|
| Rate for Payer: Multiplan Commercial |
$44.41
|
| Rate for Payer: Networks By Design Commercial |
$36.08
|
| Rate for Payer: Prime Health Services Commercial |
$47.18
|
|
|
HC CLEANSER, WOUND 6OZ SPRAY
|
Facility
|
OP
|
$55.51
|
|
|
Service Code
|
CPT A6260
|
| Hospital Charge Code |
901698238
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$47.18 |
| Rate for Payer: Adventist Health Commercial |
$11.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.09
|
| Rate for Payer: Cash Price |
$24.98
|
| Rate for Payer: Cigna of CA HMO |
$35.53
|
| Rate for Payer: Cigna of CA PPO |
$41.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.20
|
| Rate for Payer: EPIC Health Plan Senior |
$22.20
|
| Rate for Payer: Galaxy Health WC |
$47.18
|
| Rate for Payer: Global Benefits Group Commercial |
$33.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38.86
|
| Rate for Payer: Multiplan Commercial |
$44.41
|
| Rate for Payer: Networks By Design Commercial |
$36.08
|
| Rate for Payer: Prime Health Services Commercial |
$47.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.75
|
| Rate for Payer: United Healthcare All Other HMO |
$27.75
|
| Rate for Payer: United Healthcare HMO Rider |
$27.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.18
|
| Rate for Payer: Vantage Medical Group Senior |
$47.18
|
|
|
HC CLEANSER, WOUND SEA-CLENS 12OZ
|
Facility
|
IP
|
$34.28
|
|
|
Service Code
|
CPT A6260
|
| Hospital Charge Code |
901698530
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$29.14 |
| Rate for Payer: Adventist Health Commercial |
$6.86
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.71
|
| Rate for Payer: EPIC Health Plan Senior |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$29.14
|
| Rate for Payer: Global Benefits Group Commercial |
$20.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.23
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$22.28
|
| Rate for Payer: Prime Health Services Commercial |
$29.14
|
|
|
HC CLEANSER, WOUND SEA-CLENS 12OZ
|
Facility
|
OP
|
$34.28
|
|
|
Service Code
|
CPT A6260
|
| Hospital Charge Code |
901698530
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$29.14 |
| Rate for Payer: Adventist Health Commercial |
$6.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.05
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cigna of CA HMO |
$21.94
|
| Rate for Payer: Cigna of CA PPO |
$25.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.71
|
| Rate for Payer: EPIC Health Plan Senior |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$29.14
|
| Rate for Payer: Global Benefits Group Commercial |
$20.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$22.28
|
| Rate for Payer: Prime Health Services Commercial |
$29.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.14
|
| Rate for Payer: United Healthcare All Other HMO |
$17.14
|
| Rate for Payer: United Healthcare HMO Rider |
$17.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.14
|
| Rate for Payer: Vantage Medical Group Senior |
$29.14
|
|
|
HC CLEANSER WOUND SPRAY 8 OZ
|
Facility
|
OP
|
$31.65
|
|
| Hospital Charge Code |
901698908
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Cigna of CA PPO |
$23.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.16
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.82
|
| Rate for Payer: United Healthcare All Other HMO |
$15.82
|
| Rate for Payer: United Healthcare HMO Rider |
$15.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.90
|
| Rate for Payer: Vantage Medical Group Senior |
$26.90
|
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.44
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cigna of CA HMO |
$20.26
|
|
|
HC CLEANSER WOUND SPRAY 8 OZ
|
Facility
|
IP
|
$31.65
|
|
| Hospital Charge Code |
901698908
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
|
|
HC CLINICAL TRIAL PROTOCOL-OBS/HR
|
Facility
|
IP
|
$214.00
|
|
| Hospital Charge Code |
907299236
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$181.90 |
| Rate for Payer: Adventist Health Commercial |
$42.80
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: EPIC Health Plan Senior |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$132.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.36
|
| Rate for Payer: Multiplan Commercial |
$171.20
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC CLINICAL TRIAL PROTOCOL-OBS/HR
|
Facility
|
OP
|
$214.00
|
|
| Hospital Charge Code |
907299236
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$2,689.00 |
| Rate for Payer: Adventist Health Commercial |
$42.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,689.00
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: EPIC Health Plan Senior |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$132.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.80
|
| Rate for Payer: Multiplan Commercial |
$171.20
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.00
|
| Rate for Payer: United Healthcare All Other HMO |
$107.00
|
| Rate for Payer: United Healthcare HMO Rider |
$107.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.90
|
| Rate for Payer: Vantage Medical Group Senior |
$181.90
|
|
|
HC CLNSR FOAMING ANTIMICROBIAL 5OZ REMEDY
|
Facility
|
OP
|
$25.83
|
|
| Hospital Charge Code |
901606715
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$21.96 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.86
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cigna of CA HMO |
$16.53
|
| Rate for Payer: Cigna of CA PPO |
$19.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.33
|
| Rate for Payer: EPIC Health Plan Senior |
$10.33
|
| Rate for Payer: Galaxy Health WC |
$21.96
|
| Rate for Payer: Global Benefits Group Commercial |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.08
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$16.79
|
| Rate for Payer: Prime Health Services Commercial |
$21.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.91
|
| Rate for Payer: United Healthcare All Other HMO |
$12.91
|
| Rate for Payer: United Healthcare HMO Rider |
$12.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.96
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
|
HC CLNSR FOAMING ANTIMICROBIAL 5OZ REMEDY
|
Facility
|
IP
|
$25.83
|
|
| Hospital Charge Code |
901606715
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$21.96 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.33
|
| Rate for Payer: EPIC Health Plan Senior |
$10.33
|
| Rate for Payer: Galaxy Health WC |
$21.96
|
| Rate for Payer: Global Benefits Group Commercial |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$16.79
|
| Rate for Payer: Prime Health Services Commercial |
$21.96
|
|
