|
HC REPR SUB/ANT LINGL LAC LT 2.5C
|
Facility
|
IP
|
$1,322.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
900501148
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$264.40 |
| Max. Negotiated Rate |
$1,123.70 |
| Rate for Payer: Adventist Health Commercial |
$264.40
|
| Rate for Payer: Cash Price |
$594.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$528.80
|
| Rate for Payer: EPIC Health Plan Senior |
$528.80
|
| Rate for Payer: Galaxy Health WC |
$1,123.70
|
| Rate for Payer: Global Benefits Group Commercial |
$793.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$881.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$818.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.28
|
| Rate for Payer: Multiplan Commercial |
$1,057.60
|
| Rate for Payer: Networks By Design Commercial |
$859.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,123.70
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
OP
|
$7,972.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$710.20 |
| Max. Negotiated Rate |
$12,491.00 |
| Rate for Payer: Adventist Health Commercial |
$1,594.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Cash Price |
$3,587.40
|
| Rate for Payer: Cash Price |
$3,587.40
|
| Rate for Payer: Cash Price |
$3,587.40
|
| Rate for Payer: Cigna of CA HMO |
$5,102.08
|
| Rate for Payer: Cigna of CA PPO |
$5,899.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$6,776.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,783.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,317.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,913.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$6,377.60
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$5,181.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,776.20
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,783.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,986.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,986.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,986.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC REP TEND/MUSC FLEX,FOREARM
|
Facility
|
IP
|
$7,972.00
|
|
|
Service Code
|
CPT 25260
|
| Hospital Charge Code |
900501066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,594.40 |
| Max. Negotiated Rate |
$6,776.20 |
| Rate for Payer: Adventist Health Commercial |
$1,594.40
|
| Rate for Payer: Cash Price |
$3,587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,188.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,188.80
|
| Rate for Payer: Galaxy Health WC |
$6,776.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,783.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,317.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,037.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,934.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,913.28
|
| Rate for Payer: Multiplan Commercial |
$6,377.60
|
| Rate for Payer: Networks By Design Commercial |
$5,181.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,776.20
|
|
|
HC RESEARCH CLINIC VISIT
|
Facility
|
OP
|
$265.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
908600210
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.16 |
| Max. Negotiated Rate |
$225.25 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.74
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Cigna of CA HMO |
$169.60
|
| Rate for Payer: Cigna of CA PPO |
$196.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$164.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$185.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$185.50
|
| Rate for Payer: Multiplan Commercial |
$212.00
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.50
|
| Rate for Payer: United Healthcare All Other HMO |
$132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$132.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.25
|
| Rate for Payer: Vantage Medical Group Senior |
$225.25
|
|
|
HC RESEARCH CLINIC VISIT
|
Facility
|
IP
|
$265.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
908600210
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$225.25 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$164.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.60
|
| Rate for Payer: Multiplan Commercial |
$212.00
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
IP
|
$7,450.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,490.00 |
| Max. Negotiated Rate |
$6,332.50 |
| Rate for Payer: Adventist Health Commercial |
$1,490.00
|
| Rate for Payer: Cash Price |
$3,352.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,980.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,980.00
|
| Rate for Payer: Galaxy Health WC |
$6,332.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,470.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,969.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,838.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,611.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,788.00
|
| Rate for Payer: Multiplan Commercial |
$5,960.00
|
| Rate for Payer: Networks By Design Commercial |
$4,842.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,332.50
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
OP
|
$7,450.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,490.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,490.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,332.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,097.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,587.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$3,352.50
|
| Rate for Payer: Cash Price |
$3,352.50
|
| Rate for Payer: Cash Price |
$3,352.50
|
| Rate for Payer: Cigna of CA HMO |
$4,768.00
|
| Rate for Payer: Cigna of CA PPO |
$5,513.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,332.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,332.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,332.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,980.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,980.00
|
| Rate for Payer: Galaxy Health WC |
$6,332.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,470.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,740.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,969.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,230.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,611.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,788.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,215.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,215.00
|
| Rate for Payer: Multiplan Commercial |
$5,960.00
|
| Rate for Payer: Networks By Design Commercial |
$4,842.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,332.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,470.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,470.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,332.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,332.50
|
| Rate for Payer: Vantage Medical Group Senior |
$6,332.50
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
IP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$196.94 |
| Rate for Payer: Adventist Health Commercial |
$46.34
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Senior |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.61
|
| Rate for Payer: Multiplan Commercial |
$185.36
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
OP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$196.94 |
| Rate for Payer: Adventist Health Commercial |
$46.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$151.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$196.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$173.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.29
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Cigna of CA HMO |
$148.29
|
| Rate for Payer: Cigna of CA PPO |
$171.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$196.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$196.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$196.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Senior |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$162.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$162.19
|
| Rate for Payer: Multiplan Commercial |
$185.36
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.85
|
| Rate for Payer: United Healthcare All Other HMO |
$115.85
|
| Rate for Payer: United Healthcare HMO Rider |
$115.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$196.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$196.94
|
| Rate for Payer: Vantage Medical Group Senior |
$196.94
|
|
|
HC RESPIRATORY MINI PANEL
|
Facility
|
IP
|
$392.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$333.20 |
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Senior |
$156.80
|
| Rate for Payer: Galaxy Health WC |
$333.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$261.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$242.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.08
|
| Rate for Payer: Multiplan Commercial |
$313.60
|
| Rate for Payer: Networks By Design Commercial |
$254.80
|
| Rate for Payer: Prime Health Services Commercial |
$333.20
|
|
|
HC RESPIRATORY MINI PANEL
|
Facility
|
OP
|
$334.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$440.01 |
| Rate for Payer: Adventist Health Commercial |
$66.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$219.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$440.01
|
| Rate for Payer: Blue Shield of California Commercial |
$223.45
|
| Rate for Payer: Blue Shield of California EPN |
$147.63
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Cigna of CA HMO |
$213.76
|
| Rate for Payer: Cigna of CA PPO |
$247.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.55
|
| Rate for Payer: EPIC Health Plan Senior |
$142.63
|
| Rate for Payer: Galaxy Health WC |
$283.90
|
| Rate for Payer: Global Benefits Group Commercial |
$200.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$233.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$239.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$142.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$142.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$179.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.12
|
| Rate for Payer: Multiplan Commercial |
$267.20
|
| Rate for Payer: Networks By Design Commercial |
$217.10
|
| Rate for Payer: Prime Health Services Commercial |
$283.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.53
|
| Rate for Payer: United Healthcare All Other HMO |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$142.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Vantage Medical Group Senior |
$142.63
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
IP
|
$1,540.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.14 |
| Max. Negotiated Rate |
$1,309.59 |
| Rate for Payer: Adventist Health Commercial |
$308.14
|
| Rate for Payer: Cash Price |
$693.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.28
|
| Rate for Payer: EPIC Health Plan Senior |
$616.28
|
| Rate for Payer: Galaxy Health WC |
$1,309.59
|
| Rate for Payer: Global Benefits Group Commercial |
$924.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.77
|
| Rate for Payer: Multiplan Commercial |
$1,232.55
|
| Rate for Payer: Networks By Design Commercial |
$1,001.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.59
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
OP
|
$1,496.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$299.20 |
| Max. Negotiated Rate |
$3,258.75 |
| Rate for Payer: Adventist Health Commercial |
$299.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$981.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,258.75
|
| Rate for Payer: Blue Shield of California Commercial |
$1,000.82
|
| Rate for Payer: Blue Shield of California EPN |
$661.23
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cigna of CA HMO |
$957.44
|
| Rate for Payer: Cigna of CA PPO |
$1,107.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Senior |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$416.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$359.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$1,196.80
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
OP
|
$464.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$3,258.75 |
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$304.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,258.75
|
| Rate for Payer: Blue Shield of California Commercial |
$310.42
|
| Rate for Payer: Blue Shield of California EPN |
$205.09
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Senior |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$309.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$416.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$371.20
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| Rate for Payer: Prime Health Services Commercial |
$394.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$278.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
IP
|
$1,540.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.14 |
| Max. Negotiated Rate |
$1,309.59 |
| Rate for Payer: Adventist Health Commercial |
$308.14
|
| Rate for Payer: Cash Price |
$693.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.28
|
| Rate for Payer: EPIC Health Plan Senior |
$616.28
|
| Rate for Payer: Galaxy Health WC |
$1,309.59
|
| Rate for Payer: Global Benefits Group Commercial |
$924.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.77
|
| Rate for Payer: Multiplan Commercial |
$1,232.55
|
| Rate for Payer: Networks By Design Commercial |
$1,001.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.59
|
|
|
HC RESTING THALLIUM
|
Facility
|
OP
|
$3,161.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$296.69 |
| Max. Negotiated Rate |
$2,720.33 |
| Rate for Payer: Galaxy Health WC |
$2,686.85
|
| Rate for Payer: Adventist Health Commercial |
$632.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,073.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,941.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1,934.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.04
|
| Rate for Payer: Cash Price |
$1,422.45
|
| Rate for Payer: Cash Price |
$1,422.45
|
| Rate for Payer: Cigna of CA HMO |
$2,023.04
|
| Rate for Payer: Cigna of CA PPO |
$2,339.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,239.30
|
| Rate for Payer: EPIC Health Plan Senior |
$1,658.74
|
| Rate for Payer: Global Benefits Group Commercial |
$1,896.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,720.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$296.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,108.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,658.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$758.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,090.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,222.71
|
| Rate for Payer: Multiplan Commercial |
$2,528.80
|
| Rate for Payer: Networks By Design Commercial |
$2,054.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,686.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,896.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,896.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,658.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC RESTING THALLIUM
|
Facility
|
IP
|
$3,161.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$632.20 |
| Max. Negotiated Rate |
$2,686.85 |
| Rate for Payer: Adventist Health Commercial |
$632.20
|
| Rate for Payer: Cash Price |
$1,422.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,264.40
|
| Rate for Payer: Galaxy Health WC |
$2,686.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,896.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,108.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,204.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,956.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$758.64
|
| Rate for Payer: Multiplan Commercial |
$2,528.80
|
| Rate for Payer: Networks By Design Commercial |
$2,054.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,686.85
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
IP
|
$89.07
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$75.71 |
| Rate for Payer: Adventist Health Commercial |
$17.81
|
| Rate for Payer: Cash Price |
$40.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.63
|
| Rate for Payer: EPIC Health Plan Senior |
$35.63
|
| Rate for Payer: Galaxy Health WC |
$75.71
|
| Rate for Payer: Global Benefits Group Commercial |
$53.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.38
|
| Rate for Payer: Multiplan Commercial |
$71.26
|
| Rate for Payer: Networks By Design Commercial |
$57.90
|
| Rate for Payer: Prime Health Services Commercial |
$75.71
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
OP
|
$89.07
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$75.71 |
| Rate for Payer: Adventist Health Commercial |
$17.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.70
|
| Rate for Payer: Cash Price |
$40.08
|
| Rate for Payer: Cigna of CA HMO |
$57.00
|
| Rate for Payer: Cigna of CA PPO |
$65.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.63
|
| Rate for Payer: EPIC Health Plan Senior |
$35.63
|
| Rate for Payer: Galaxy Health WC |
$75.71
|
| Rate for Payer: Global Benefits Group Commercial |
$53.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.35
|
| Rate for Payer: Multiplan Commercial |
$71.26
|
| Rate for Payer: Networks By Design Commercial |
$57.90
|
| Rate for Payer: Prime Health Services Commercial |
$75.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.53
|
| Rate for Payer: United Healthcare All Other HMO |
$44.53
|
| Rate for Payer: United Healthcare HMO Rider |
$44.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.71
|
| Rate for Payer: Vantage Medical Group Senior |
$75.71
|
|
|
HC RESUSCITATOR MANUAL ADULT
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901605546
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901605546
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.36
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
OP
|
$82.16
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$69.84 |
| Rate for Payer: Adventist Health Commercial |
$16.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.45
|
| Rate for Payer: Cash Price |
$36.97
|
| Rate for Payer: Cigna of CA HMO |
$52.58
|
| Rate for Payer: Cigna of CA PPO |
$60.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.86
|
| Rate for Payer: EPIC Health Plan Senior |
$32.86
|
| Rate for Payer: Galaxy Health WC |
$69.84
|
| Rate for Payer: Global Benefits Group Commercial |
$49.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.51
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: Networks By Design Commercial |
$53.40
|
| Rate for Payer: Prime Health Services Commercial |
$69.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.08
|
| Rate for Payer: United Healthcare All Other HMO |
$41.08
|
| Rate for Payer: United Healthcare HMO Rider |
$41.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.84
|
| Rate for Payer: Vantage Medical Group Senior |
$69.84
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
IP
|
$82.16
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$69.84 |
| Rate for Payer: Adventist Health Commercial |
$16.43
|
| Rate for Payer: Cash Price |
$36.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.86
|
| Rate for Payer: EPIC Health Plan Senior |
$32.86
|
| Rate for Payer: Galaxy Health WC |
$69.84
|
| Rate for Payer: Global Benefits Group Commercial |
$49.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.72
|
| Rate for Payer: Multiplan Commercial |
$65.73
|
| Rate for Payer: Networks By Design Commercial |
$53.40
|
| Rate for Payer: Prime Health Services Commercial |
$69.84
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
IP
|
$108.50
|
|
| Hospital Charge Code |
901605545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.70 |
| Max. Negotiated Rate |
$92.22 |
| Rate for Payer: Adventist Health Commercial |
$21.70
|
| Rate for Payer: Cash Price |
$48.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.40
|
| Rate for Payer: EPIC Health Plan Senior |
$43.40
|
| Rate for Payer: Galaxy Health WC |
$92.22
|
| Rate for Payer: Global Benefits Group Commercial |
$65.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.04
|
| Rate for Payer: Multiplan Commercial |
$86.80
|
| Rate for Payer: Networks By Design Commercial |
$70.53
|
| Rate for Payer: Prime Health Services Commercial |
$92.22
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
OP
|
$95.91
|
|
| Hospital Charge Code |
901607889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$81.52 |
| Rate for Payer: Adventist Health Commercial |
$19.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.90
|
| Rate for Payer: Cash Price |
$43.16
|
| Rate for Payer: Cigna of CA HMO |
$61.38
|
| Rate for Payer: Cigna of CA PPO |
$70.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.36
|
| Rate for Payer: EPIC Health Plan Senior |
$38.36
|
| Rate for Payer: Galaxy Health WC |
$81.52
|
| Rate for Payer: Global Benefits Group Commercial |
$57.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.14
|
| Rate for Payer: Multiplan Commercial |
$76.73
|
| Rate for Payer: Networks By Design Commercial |
$62.34
|
| Rate for Payer: Prime Health Services Commercial |
$81.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.95
|
| Rate for Payer: United Healthcare All Other HMO |
$47.95
|
| Rate for Payer: United Healthcare HMO Rider |
$47.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.52
|
| Rate for Payer: Vantage Medical Group Senior |
$81.52
|
|
