|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,215.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$4,730.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,395.50
|
| 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 |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,215.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$4,730.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,230.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,395.50
|
| 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 |
$3,725.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$162.19
|
| 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 Foundation Hospitals Commercial/Self Funded |
$147.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$136.70
|
| 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 |
$148.68
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$162.19
|
| 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 Foundation Hospitals Commercial/Self Funded |
$147.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$136.70
|
| 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
|
OP
|
$334.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$991.59 |
| Rate for Payer: Adventist Health Commercial |
$66.80
|
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$991.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$991.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.94
|
| 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 Medi-Cal |
$156.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$459.81
|
| Rate for Payer: Blue Shield of California Commercial |
$180.71
|
| Rate for Payer: Blue Shield of California Commercial |
$153.97
|
| Rate for Payer: Blue Shield of California Commercial |
$273.22
|
| Rate for Payer: Blue Shield of California Commercial |
$232.80
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Cigna of CA HMO |
$250.88
|
| Rate for Payer: Cigna of CA HMO |
$213.76
|
| Rate for Payer: Cigna of CA PPO |
$247.16
|
| Rate for Payer: Cigna of CA PPO |
$290.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$233.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: EPIC Health Plan Senior |
$156.89
|
| Rate for Payer: EPIC Health Plan Senior |
$156.89
|
| Rate for Payer: Galaxy Health WC |
$283.90
|
| Rate for Payer: Galaxy Health WC |
$333.20
|
| Rate for Payer: Global Benefits Group Commercial |
$200.40
|
| Rate for Payer: Global Benefits Group Commercial |
$235.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$233.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$233.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$239.62
|
| 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: Inland Empire Health Plan (IEHP) Medicare Advantage |
$142.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$212.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$248.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$199.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$199.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$179.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$179.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.12
|
| Rate for Payer: Multiplan Commercial |
$313.60
|
| Rate for Payer: Multiplan Commercial |
$267.20
|
| Rate for Payer: Networks By Design Commercial |
$254.80
|
| Rate for Payer: Networks By Design Commercial |
$217.10
|
| Rate for Payer: Prime Health Services Commercial |
$283.90
|
| Rate for Payer: Prime Health Services Commercial |
$333.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.53
|
| 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 All Other HMO |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$142.63
|
| 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 Commercial/Exchange |
$213.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Vantage Medical Group Senior |
$142.63
|
| Rate for Payer: Vantage Medical Group Senior |
$142.63
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$274.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$248.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.28
|
| 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 PANEL, NUCLEIC ACID
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,309.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.60
|
| Rate for Payer: Multiplan Commercial |
$1,232.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$3,405.38 |
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,385.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,385.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| 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 Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,405.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,405.38
|
| Rate for Payer: Blue Shield of California Commercial |
$213.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,073.38
|
| Rate for Payer: Blue Shield of California Commercial |
$323.41
|
| Rate for Payer: Blue Shield of California Commercial |
$709.94
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.39
|
| 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: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.60
|
| 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 Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$371.20
|
| Rate for Payer: Multiplan Commercial |
$1,232.00
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Commercial |
$394.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.00
|
| 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 Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$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 HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| 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 Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$3,405.38 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,385.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,385.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| 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 Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,405.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,405.38
|
| Rate for Payer: Blue Shield of California Commercial |
$213.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,073.38
|
| Rate for Payer: Blue Shield of California Commercial |
$323.41
|
| Rate for Payer: Blue Shield of California Commercial |
$709.94
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$622.39
|
| 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: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.60
|
| 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 Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$371.20
|
| Rate for Payer: Multiplan Commercial |
$1,232.00
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Commercial |
$394.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.00
|
| 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 Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$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 HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| 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 Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,309.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$369.60
|
| Rate for Payer: Multiplan Commercial |
$1,232.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
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 |
$2,747.46 |
| Rate for Payer: Adventist Health Commercial |
$632.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,763.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,028.41
|
| Rate for Payer: Blue Shield of California Commercial |
$2,016.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,330.78
|
| 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 |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,212.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,747.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,831.64
|
| Rate for Payer: Galaxy Health WC |
$2,686.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,896.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,730.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$296.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,007.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$335.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,331.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$758.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,098.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,231.27
|
| 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 |
$1,665.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,212.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,007.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,864.99
|
| 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
|
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 |
$57.16
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.35
|
| 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 Foundation Hospitals Commercial/Self Funded |
$56.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.55
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.35
|
| 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 Foundation Hospitals Commercial/Self Funded |
$56.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.55
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| 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 |
$52.62
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.51
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.47
|
| 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 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 |
$52.72
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.51
|
| 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 Foundation Hospitals Commercial/Self Funded |
$52.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.47
|
| 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 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 |
$61.55
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.14
|
| 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 Foundation Hospitals Commercial/Self Funded |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.59
|
| 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
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
IP
|
$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: Cash Price |
$43.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.14
|
| 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 Foundation Hospitals Commercial/Self Funded |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.02
|
| 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
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$71.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$92.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.62
|
| Rate for Payer: Cash Price |
$48.82
|
| Rate for Payer: Cigna of CA HMO |
$69.44
|
| Rate for Payer: Cigna of CA PPO |
$80.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$92.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$92.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$92.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.95
|
| 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 Foundation Hospitals Commercial/Self Funded |
$68.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$64.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75.95
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$54.25
|
| Rate for Payer: United Healthcare All Other HMO |
$54.25
|
| Rate for Payer: United Healthcare HMO Rider |
$54.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$92.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$92.22
|
| Rate for Payer: Vantage Medical Group Senior |
$92.22
|
|
|
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 |
$48.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.95
|
| 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 Foundation Hospitals Commercial/Self Funded |
$68.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$64.02
|
| 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 PEDS
|
Facility
|
OP
|
$128.82
|
|
| Hospital Charge Code |
901605544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.76 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Adventist Health Commercial |
$25.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$84.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$109.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.66
|
| Rate for Payer: Cash Price |
$57.97
|
| Rate for Payer: Cigna of CA HMO |
$82.44
|
| Rate for Payer: Cigna of CA PPO |
$95.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$109.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$109.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$90.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.53
|
| Rate for Payer: EPIC Health Plan Senior |
$51.53
|
| Rate for Payer: Galaxy Health WC |
$109.50
|
| Rate for Payer: Global Benefits Group Commercial |
$77.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$81.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$76.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.17
|
| Rate for Payer: Multiplan Commercial |
$103.06
|
| Rate for Payer: Networks By Design Commercial |
$83.73
|
| Rate for Payer: Prime Health Services Commercial |
$109.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.41
|
| Rate for Payer: United Healthcare All Other HMO |
$64.41
|
| Rate for Payer: United Healthcare HMO Rider |
$64.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$109.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.50
|
| Rate for Payer: Vantage Medical Group Senior |
$109.50
|
|
|
HC RESUSCITATOR MANUAL PEDS
|
Facility
|
OP
|
$122.74
|
|
| Hospital Charge Code |
901607888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$104.33 |
| Rate for Payer: Adventist Health Commercial |
$24.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.76
|
| Rate for Payer: Cash Price |
$55.23
|
| Rate for Payer: Cigna of CA HMO |
$78.55
|
| Rate for Payer: Cigna of CA PPO |
$90.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.10
|
| Rate for Payer: EPIC Health Plan Senior |
$49.10
|
| Rate for Payer: Galaxy Health WC |
$104.33
|
| Rate for Payer: Global Benefits Group Commercial |
$73.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85.92
|
| Rate for Payer: Multiplan Commercial |
$98.19
|
| Rate for Payer: Networks By Design Commercial |
$79.78
|
| Rate for Payer: Prime Health Services Commercial |
$104.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.37
|
| Rate for Payer: United Healthcare All Other HMO |
$61.37
|
| Rate for Payer: United Healthcare HMO Rider |
$61.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.33
|
| Rate for Payer: Vantage Medical Group Senior |
$104.33
|
|
|
HC RESUSCITATOR MANUAL PEDS
|
Facility
|
IP
|
$122.74
|
|
| Hospital Charge Code |
901607888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$104.33 |
| Rate for Payer: Adventist Health Commercial |
$24.55
|
| Rate for Payer: Cash Price |
$55.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.10
|
| Rate for Payer: EPIC Health Plan Senior |
$49.10
|
| Rate for Payer: Galaxy Health WC |
$104.33
|
| Rate for Payer: Global Benefits Group Commercial |
$73.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.46
|
| Rate for Payer: Multiplan Commercial |
$98.19
|
| Rate for Payer: Networks By Design Commercial |
$79.78
|
| Rate for Payer: Prime Health Services Commercial |
$104.33
|
|
