|
HC STUMP SOCK SINGLE PLY BK EACH
|
Facility
IP
|
$32.00
|
|
|
Service Code
|
CPT L8470
|
| Hospital Charge Code |
905358470
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Blue Shield of California EPN |
$17.09
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$22.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.80
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$16.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
|
|
HC STUMP SOCK SNGLE PLY UPPER LMB
|
Facility
OP
|
$47.00
|
|
|
Service Code
|
CPT L8485
|
| Hospital Charge Code |
905358485
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$49.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.77
|
| Rate for Payer: BCBS Transplant Transplant |
$28.20
|
| Rate for Payer: Blue Shield of California Commercial |
$35.25
|
| Rate for Payer: Blue Shield of California EPN |
$25.57
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Cigna of CA HMO |
$32.90
|
| Rate for Payer: Cigna of CA PPO |
$32.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35.25
|
| Rate for Payer: IEHP medi-cal |
$16.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.27
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$23.50
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Riverside University Health MISP |
$18.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.50
|
| Rate for Payer: United Healthcare All Other HMO |
$23.50
|
| Rate for Payer: United Healthcare HMO Rider |
$23.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.95
|
| Rate for Payer: Vantage Medical Group Senior |
$39.95
|
|
|
HC STUMP SOCK SNGLE PLY UPPER LMB
|
Facility
IP
|
$47.00
|
|
|
Service Code
|
CPT L8485
|
| Hospital Charge Code |
905358485
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Blue Shield of California EPN |
$25.10
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Cigna of CA HMO |
$32.90
|
| Rate for Payer: Cigna of CA PPO |
$32.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$23.50
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC STYE INCISION OF LID MARGIN
|
Facility
OP
|
$2,990.00
|
|
|
Service Code
|
CPT 67830
|
| Hospital Charge Code |
900501664
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,264.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,794.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,264.97
|
| Rate for Payer: Cash Price |
$1,345.50
|
| Rate for Payer: Cash Price |
$1,345.50
|
| Rate for Payer: Cash Price |
$1,345.50
|
| Rate for Payer: Cash Price |
$1,345.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,392.00
|
| Rate for Payer: Cigna of CA PPO |
$2,212.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,897.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,707.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,264.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,264.97
|
| Rate for Payer: Galaxy Health WC |
$2,541.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,794.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,691.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,242.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,074.55
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,264.97
|
| Rate for Payer: Innovage PACE Commercial |
$1,897.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,994.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,264.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$598.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,695.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,695.06
|
| Rate for Payer: Multiplan Commercial |
$2,242.50
|
| Rate for Payer: Networks By Design Commercial |
$1,943.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,541.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,340.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,794.00
|
| Rate for Payer: Riverside University Health MISP |
$1,391.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,794.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,495.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,495.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,495.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,495.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,897.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,391.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1,264.97
|
|
|
HC STYE INCISION OF LID MARGIN
|
Facility
IP
|
$2,990.00
|
|
|
Service Code
|
CPT 67830
|
| Hospital Charge Code |
900501664
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$598.00 |
| Max. Negotiated Rate |
$2,691.00 |
| Rate for Payer: Cash Price |
$1,345.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,392.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,196.00
|
| Rate for Payer: Galaxy Health WC |
$2,541.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,794.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,691.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,994.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$598.00
|
| Rate for Payer: Multiplan Commercial |
$2,242.50
|
| Rate for Payer: Networks By Design Commercial |
$1,943.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,541.50
|
|
|
HC STYLET INTUBATION 12FR
|
Facility
IP
|
$19.43
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$17.49 |
| Rate for Payer: Cash Price |
$8.74
|
| Rate for Payer: Central Health Plan Commercial |
$15.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.77
|
| Rate for Payer: Galaxy Health WC |
$16.52
|
| Rate for Payer: Global Benefits Group Commercial |
$11.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.89
|
| Rate for Payer: Multiplan Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$12.63
|
| Rate for Payer: Prime Health Services Commercial |
$16.52
|
|
|
HC STYLET INTUBATION 12FR
|
Facility
OP
|
$19.43
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698672
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$17.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.48
|
| Rate for Payer: BCBS Transplant Transplant |
$11.66
|
| Rate for Payer: Blue Shield of California Commercial |
$12.22
|
| Rate for Payer: Blue Shield of California EPN |
$9.50
|
| Rate for Payer: Cash Price |
$8.74
|
| Rate for Payer: Cash Price |
$8.74
|
| Rate for Payer: Central Health Plan Commercial |
$15.54
|
| Rate for Payer: Cigna of CA HMO |
$12.44
|
| Rate for Payer: Cigna of CA PPO |
$14.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.77
|
| Rate for Payer: Galaxy Health WC |
$16.52
|
| Rate for Payer: Global Benefits Group Commercial |
$11.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.57
|
| Rate for Payer: IEHP medi-cal |
$6.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.89
|
| Rate for Payer: Multiplan Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$12.63
|
| Rate for Payer: Prime Health Services Commercial |
$16.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.66
|
| Rate for Payer: Riverside University Health MISP |
$7.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.72
|
| Rate for Payer: United Healthcare All Other HMO |
$9.72
|
| Rate for Payer: United Healthcare HMO Rider |
$9.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.52
|
| Rate for Payer: Vantage Medical Group Senior |
$16.52
|
|
|
HC STYLET, INTUBATION, 14FR
|
Facility
OP
|
$13.69
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$16.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.09
|
| Rate for Payer: BCBS Transplant Transplant |
$8.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8.61
|
| Rate for Payer: Blue Shield of California EPN |
$6.69
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Central Health Plan Commercial |
$10.95
|
| Rate for Payer: Cigna of CA HMO |
$8.76
|
| Rate for Payer: Cigna of CA PPO |
$10.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.27
|
| Rate for Payer: IEHP medi-cal |
$4.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.74
|
| Rate for Payer: Multiplan Commercial |
$10.27
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.21
|
| Rate for Payer: Riverside University Health MISP |
$5.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.84
|
| Rate for Payer: United Healthcare All Other HMO |
$6.84
|
| Rate for Payer: United Healthcare HMO Rider |
$6.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Vantage Medical Group Senior |
$11.64
|
|
|
HC STYLET, INTUBATION, 14FR
|
Facility
IP
|
$13.69
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607910
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Central Health Plan Commercial |
$10.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.74
|
| Rate for Payer: Multiplan Commercial |
$10.27
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
|
|
HC STYLET INTUBATION 2.5-4.5MM
|
Facility
OP
|
$20.01
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.82
|
| Rate for Payer: BCBS Transplant Transplant |
$12.01
|
| Rate for Payer: Blue Shield of California Commercial |
$12.59
|
| Rate for Payer: Blue Shield of California EPN |
$9.78
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.01
|
| Rate for Payer: Cigna of CA HMO |
$12.81
|
| Rate for Payer: Cigna of CA PPO |
$14.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.01
|
| Rate for Payer: Global Benefits Group Commercial |
$12.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.01
|
| Rate for Payer: IEHP medi-cal |
$7.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.01
|
| Rate for Payer: Networks By Design Commercial |
$13.01
|
| Rate for Payer: Prime Health Services Commercial |
$17.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.01
|
| Rate for Payer: Riverside University Health MISP |
$8.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.01
|
| Rate for Payer: Vantage Medical Group Senior |
$17.01
|
|
|
HC STYLET INTUBATION 2.5-4.5MM
|
Facility
IP
|
$20.01
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.01
|
| Rate for Payer: Global Benefits Group Commercial |
$12.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.01
|
| Rate for Payer: Networks By Design Commercial |
$13.01
|
| Rate for Payer: Prime Health Services Commercial |
$17.01
|
|
|
HC STYLET INTUBATION 5.0-7.5MM
|
Facility
OP
|
$20.01
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.82
|
| Rate for Payer: BCBS Transplant Transplant |
$12.01
|
| Rate for Payer: Blue Shield of California Commercial |
$12.59
|
| Rate for Payer: Blue Shield of California EPN |
$9.78
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.01
|
| Rate for Payer: Cigna of CA HMO |
$12.81
|
| Rate for Payer: Cigna of CA PPO |
$14.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.01
|
| Rate for Payer: Global Benefits Group Commercial |
$12.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.01
|
| Rate for Payer: IEHP medi-cal |
$7.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.01
|
| Rate for Payer: Networks By Design Commercial |
$13.01
|
| Rate for Payer: Prime Health Services Commercial |
$17.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.01
|
| Rate for Payer: Riverside University Health MISP |
$8.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.01
|
| Rate for Payer: Vantage Medical Group Senior |
$17.01
|
|
|
HC STYLET INTUBATION 5.0-7.5MM
|
Facility
IP
|
$20.01
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.01
|
| Rate for Payer: Global Benefits Group Commercial |
$12.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.01
|
| Rate for Payer: Networks By Design Commercial |
$13.01
|
| Rate for Payer: Prime Health Services Commercial |
$17.01
|
|
|
HC STYLET INTUBATION 6FR
|
Facility
OP
|
$19.19
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$396.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.34
|
| Rate for Payer: BCBS Transplant Transplant |
$11.51
|
| Rate for Payer: Blue Shield of California Commercial |
$12.07
|
| Rate for Payer: Blue Shield of California EPN |
$9.38
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.35
|
| Rate for Payer: Cigna of CA HMO |
$12.28
|
| Rate for Payer: Cigna of CA PPO |
$14.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.68
|
| Rate for Payer: Galaxy Health WC |
$16.31
|
| Rate for Payer: Global Benefits Group Commercial |
$11.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.39
|
| Rate for Payer: IEHP medi-cal |
$6.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.39
|
| Rate for Payer: Networks By Design Commercial |
$12.47
|
| Rate for Payer: Prime Health Services Commercial |
$16.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.51
|
| Rate for Payer: Riverside University Health MISP |
$7.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.60
|
| Rate for Payer: United Healthcare All Other HMO |
$9.60
|
| Rate for Payer: United Healthcare HMO Rider |
$9.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.31
|
| Rate for Payer: Vantage Medical Group Senior |
$16.31
|
|
|
HC STYLET INTUBATION 6FR
|
Facility
IP
|
$19.19
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698734
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$17.27 |
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: Galaxy Health WC |
$16.31
|
| Rate for Payer: Global Benefits Group Commercial |
$11.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.39
|
| Rate for Payer: Networks By Design Commercial |
$12.47
|
| Rate for Payer: Prime Health Services Commercial |
$16.31
|
|
|
HC STYLET INTUBATION 6FR LUBR
|
Facility
IP
|
$2,300.00
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698670
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC STYLET INTUBATION 6FR LUBR
|
Facility
OP
|
$2,300.00
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698670
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.01 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,265.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,358.84
|
| Rate for Payer: BCBS Transplant Transplant |
$1,380.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,446.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,124.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,725.00
|
| Rate for Payer: IEHP medi-cal |
$805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: Riverside University Health MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC STYLET INTUBATION 7.5-9.5MM
|
Facility
IP
|
$19.93
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Cash Price |
$8.97
|
| Rate for Payer: Central Health Plan Commercial |
$15.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.97
|
| Rate for Payer: Galaxy Health WC |
$16.94
|
| Rate for Payer: Global Benefits Group Commercial |
$11.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.99
|
| Rate for Payer: Multiplan Commercial |
$14.95
|
| Rate for Payer: Networks By Design Commercial |
$12.95
|
| Rate for Payer: Prime Health Services Commercial |
$16.94
|
|
|
HC STYLET INTUBATION 7.5-9.5MM
|
Facility
OP
|
$19.93
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.77
|
| Rate for Payer: BCBS Transplant Transplant |
$11.96
|
| Rate for Payer: Blue Shield of California Commercial |
$12.54
|
| Rate for Payer: Blue Shield of California EPN |
$9.75
|
| Rate for Payer: Cash Price |
$8.97
|
| Rate for Payer: Cash Price |
$8.97
|
| Rate for Payer: Central Health Plan Commercial |
$15.94
|
| Rate for Payer: Cigna of CA HMO |
$12.76
|
| Rate for Payer: Cigna of CA PPO |
$14.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.97
|
| Rate for Payer: Galaxy Health WC |
$16.94
|
| Rate for Payer: Global Benefits Group Commercial |
$11.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.95
|
| Rate for Payer: IEHP medi-cal |
$6.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.99
|
| Rate for Payer: Multiplan Commercial |
$14.95
|
| Rate for Payer: Networks By Design Commercial |
$12.95
|
| Rate for Payer: Prime Health Services Commercial |
$16.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.96
|
| Rate for Payer: Riverside University Health MISP |
$7.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.96
|
| Rate for Payer: United Healthcare All Other HMO |
$9.96
|
| Rate for Payer: United Healthcare HMO Rider |
$9.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.94
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
|
|
HC STYLET SLICK INTUBATION 8FR
|
Facility
OP
|
$22.14
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.08
|
| Rate for Payer: BCBS Transplant Transplant |
$13.28
|
| Rate for Payer: Blue Shield of California Commercial |
$13.93
|
| Rate for Payer: Blue Shield of California EPN |
$10.83
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.60
|
| Rate for Payer: IEHP medi-cal |
$7.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: Riverside University Health MISP |
$8.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC STYLET SLICK INTUBATION 8FR
|
Facility
IP
|
$22.14
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901607537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC STYLET VASONOVA VPS
|
Facility
IP
|
$583.83
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.77 |
| Max. Negotiated Rate |
$525.45 |
| Rate for Payer: Cash Price |
$262.72
|
| Rate for Payer: Central Health Plan Commercial |
$467.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.53
|
| Rate for Payer: Galaxy Health WC |
$496.26
|
| Rate for Payer: Global Benefits Group Commercial |
$350.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.77
|
| Rate for Payer: Multiplan Commercial |
$437.87
|
| Rate for Payer: Networks By Design Commercial |
$379.49
|
| Rate for Payer: Prime Health Services Commercial |
$496.26
|
|
|
HC STYLET VASONOVA VPS
|
Facility
OP
|
$583.83
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
901698323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.77 |
| Max. Negotiated Rate |
$525.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$496.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$321.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$321.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$282.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$344.93
|
| Rate for Payer: BCBS Transplant Transplant |
$350.30
|
| Rate for Payer: Blue Shield of California Commercial |
$367.23
|
| Rate for Payer: Blue Shield of California EPN |
$285.49
|
| Rate for Payer: Cash Price |
$262.72
|
| Rate for Payer: Cash Price |
$262.72
|
| Rate for Payer: Central Health Plan Commercial |
$467.06
|
| Rate for Payer: Cigna of CA HMO |
$373.65
|
| Rate for Payer: Cigna of CA PPO |
$432.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$496.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.53
|
| Rate for Payer: Galaxy Health WC |
$496.26
|
| Rate for Payer: Global Benefits Group Commercial |
$350.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.45
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$437.87
|
| Rate for Payer: IEHP medi-cal |
$204.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.77
|
| Rate for Payer: Multiplan Commercial |
$437.87
|
| Rate for Payer: Networks By Design Commercial |
$379.49
|
| Rate for Payer: Prime Health Services Commercial |
$496.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$350.30
|
| Rate for Payer: Riverside University Health MISP |
$233.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$350.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$350.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.92
|
| Rate for Payer: United Healthcare All Other HMO |
$291.92
|
| Rate for Payer: United Healthcare HMO Rider |
$291.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$496.26
|
| Rate for Payer: Vantage Medical Group Senior |
$496.26
|
|
|
HC SUBC THER INFUSION EA ADD HR
|
Facility
OP
|
$105.00
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
907296370
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$63.00
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: IEHP medi-cal |
$97.93
|
| Rate for Payer: IEHP Medicare Advantage |
$59.35
|
| Rate for Payer: Innovage PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$65.28
|
| Rate for Payer: Riverside University Health MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC SUBC THER INFUSION EA ADD HR
|
Facility
IP
|
$105.00
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
907296370
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
|
