|
HC TTS BIVONA NEO CUFFED 3.5MM
|
Facility
|
IP
|
$843.41
|
|
| Hospital Charge Code |
900800908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
|
|
HC TTS BIVONA NEO CUFFED 4.0MM
|
Facility
|
OP
|
$843.41
|
|
| Hospital Charge Code |
900800907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$512.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$632.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.61
|
| Rate for Payer: Blue Shield of California Commercial |
$534.72
|
| Rate for Payer: Blue Shield of California EPN |
$336.52
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Cigna of CA HMO |
$539.78
|
| Rate for Payer: Cigna of CA PPO |
$624.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$716.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$716.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$716.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$590.39
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
| Rate for Payer: Riverside University Health System MISP |
$337.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.70
|
| Rate for Payer: United Healthcare All Other HMO |
$421.70
|
| Rate for Payer: United Healthcare HMO Rider |
$421.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$716.90
|
| Rate for Payer: Vantage Medical Group Senior |
$716.90
|
|
|
HC TTS BIVONA NEO CUFFED 4.0MM
|
Facility
|
IP
|
$843.41
|
|
| Hospital Charge Code |
900800907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 3.5MM
|
Facility
|
IP
|
$843.41
|
|
| Hospital Charge Code |
900800906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 3.5MM
|
Facility
|
OP
|
$843.41
|
|
| Hospital Charge Code |
900800906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$512.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$632.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.61
|
| Rate for Payer: Blue Shield of California Commercial |
$534.72
|
| Rate for Payer: Blue Shield of California EPN |
$336.52
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Cigna of CA HMO |
$539.78
|
| Rate for Payer: Cigna of CA PPO |
$624.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$716.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$716.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$716.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$590.39
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
| Rate for Payer: Riverside University Health System MISP |
$337.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.70
|
| Rate for Payer: United Healthcare All Other HMO |
$421.70
|
| Rate for Payer: United Healthcare HMO Rider |
$421.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$716.90
|
| Rate for Payer: Vantage Medical Group Senior |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 4.0MM
|
Facility
|
OP
|
$843.41
|
|
| Hospital Charge Code |
900800905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$512.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$632.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.61
|
| Rate for Payer: Blue Shield of California Commercial |
$534.72
|
| Rate for Payer: Blue Shield of California EPN |
$336.52
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Cigna of CA HMO |
$539.78
|
| Rate for Payer: Cigna of CA PPO |
$624.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$716.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$716.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$716.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$590.39
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
| Rate for Payer: Riverside University Health System MISP |
$337.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.70
|
| Rate for Payer: United Healthcare All Other HMO |
$421.70
|
| Rate for Payer: United Healthcare HMO Rider |
$421.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$716.90
|
| Rate for Payer: Vantage Medical Group Senior |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 4.0MM
|
Facility
|
IP
|
$843.41
|
|
| Hospital Charge Code |
900800905
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 4.5MM
|
Facility
|
IP
|
$843.41
|
|
| Hospital Charge Code |
900800904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
|
|
HC TTS BIVONA PEDS CUFFED 4.5MM
|
Facility
|
OP
|
$843.41
|
|
| Hospital Charge Code |
900800904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.68 |
| Max. Negotiated Rate |
$759.07 |
| Rate for Payer: Adventist Health Commercial |
$168.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$512.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$632.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.61
|
| Rate for Payer: Blue Shield of California Commercial |
$534.72
|
| Rate for Payer: Blue Shield of California EPN |
$336.52
|
| Rate for Payer: Cash Price |
$379.53
|
| Rate for Payer: Central Health Plan Commercial |
$674.73
|
| Rate for Payer: Cigna of CA HMO |
$539.78
|
| Rate for Payer: Cigna of CA PPO |
$624.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$716.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$716.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$716.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$590.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.36
|
| Rate for Payer: EPIC Health Plan Senior |
$337.36
|
| Rate for Payer: Galaxy Health WC |
$716.90
|
| Rate for Payer: Global Benefits Group Commercial |
$506.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$535.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$306.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$497.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$590.39
|
| Rate for Payer: Multiplan Commercial |
$632.56
|
| Rate for Payer: Networks By Design Commercial |
$548.22
|
| Rate for Payer: Prime Health Services Commercial |
$716.90
|
| Rate for Payer: Riverside University Health System MISP |
$337.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.70
|
| Rate for Payer: United Healthcare All Other HMO |
$421.70
|
| Rate for Payer: United Healthcare HMO Rider |
$421.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$716.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$716.90
|
| Rate for Payer: Vantage Medical Group Senior |
$716.90
|
|
|
HC T-TUBE CHOLANGIOGRAM INJ
|
Facility
|
IP
|
$2,860.00
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
909000191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.00 |
| Max. Negotiated Rate |
$2,574.00 |
| Rate for Payer: Adventist Health Commercial |
$572.00
|
| Rate for Payer: Cash Price |
$1,287.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,288.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,002.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,144.00
|
| Rate for Payer: Galaxy Health WC |
$2,431.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,716.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,574.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,816.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,687.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Multiplan Commercial |
$2,145.00
|
| Rate for Payer: Networks By Design Commercial |
$1,859.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,431.00
|
|
|
HC T-TUBE CHOLANGIOGRAM INJ
|
Facility
|
OP
|
$2,860.00
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
909000191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$572.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,604.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,144.49
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,287.00
|
| Rate for Payer: Cash Price |
$1,287.00
|
| Rate for Payer: Cash Price |
$1,287.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,288.00
|
| Rate for Payer: Cigna of CA HMO |
$1,830.40
|
| Rate for Payer: Cigna of CA PPO |
$2,116.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,002.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$2,431.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,716.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,574.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,816.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$2,145.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$1,859.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Preferred Health Network WC |
$7,290.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,431.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,881.29
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$5,065.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,716.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,430.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC TUBE BIVONA AIR CUFF PEDS
|
Facility
|
IP
|
$738.00
|
|
| Hospital Charge Code |
900800708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Adventist Health Commercial |
$147.60
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$516.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.20
|
| Rate for Payer: EPIC Health Plan Senior |
$295.20
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$468.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$435.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
|
|
HC TUBE BIVONA AIR CUFF PEDS
|
Facility
|
OP
|
$738.00
|
|
| Hospital Charge Code |
900800708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Adventist Health Commercial |
$147.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$448.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$627.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$405.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$357.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$429.29
|
| Rate for Payer: Blue Shield of California Commercial |
$467.89
|
| Rate for Payer: Blue Shield of California EPN |
$294.46
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: Cigna of CA HMO |
$472.32
|
| Rate for Payer: Cigna of CA PPO |
$546.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$627.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$627.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$627.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$516.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.20
|
| Rate for Payer: EPIC Health Plan Senior |
$295.20
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$468.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$267.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$435.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$516.60
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
| Rate for Payer: Riverside University Health System MISP |
$295.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$442.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$442.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$369.00
|
| Rate for Payer: United Healthcare All Other HMO |
$369.00
|
| Rate for Payer: United Healthcare HMO Rider |
$369.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$627.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$627.30
|
| Rate for Payer: Vantage Medical Group Senior |
$627.30
|
|
|
HC TUBE CHECK (ABSCESS/CYST)
|
Facility
|
IP
|
$381.00
|
|
|
Service Code
|
CPT 49424
|
| Hospital Charge Code |
909000212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$76.20 |
| Max. Negotiated Rate |
$342.90 |
| Rate for Payer: Adventist Health Commercial |
$76.20
|
| Rate for Payer: Cash Price |
$171.45
|
| Rate for Payer: Central Health Plan Commercial |
$304.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$266.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.40
|
| Rate for Payer: EPIC Health Plan Senior |
$152.40
|
| Rate for Payer: Galaxy Health WC |
$323.85
|
| Rate for Payer: Global Benefits Group Commercial |
$228.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$342.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$241.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.20
|
| Rate for Payer: Multiplan Commercial |
$285.75
|
| Rate for Payer: Networks By Design Commercial |
$247.65
|
| Rate for Payer: Prime Health Services Commercial |
$323.85
|
|
|
HC TUBE CHECK (ABSCESS/CYST)
|
Facility
|
OP
|
$381.00
|
|
|
Service Code
|
CPT 49424
|
| Hospital Charge Code |
909000212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$76.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$323.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$209.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$285.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$171.45
|
| Rate for Payer: Cash Price |
$171.45
|
| Rate for Payer: Cash Price |
$171.45
|
| Rate for Payer: Central Health Plan Commercial |
$304.80
|
| Rate for Payer: Cigna of CA HMO |
$243.84
|
| Rate for Payer: Cigna of CA PPO |
$281.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$323.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$323.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$266.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.40
|
| Rate for Payer: EPIC Health Plan Senior |
$152.40
|
| Rate for Payer: Galaxy Health WC |
$323.85
|
| Rate for Payer: Global Benefits Group Commercial |
$228.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$342.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$241.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$266.70
|
| Rate for Payer: Multiplan Commercial |
$285.75
|
| Rate for Payer: Networks By Design Commercial |
$247.65
|
| Rate for Payer: Prime Health Services Commercial |
$323.85
|
| Rate for Payer: Riverside University Health System MISP |
$152.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$228.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$190.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$323.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$323.85
|
| Rate for Payer: Vantage Medical Group Senior |
$323.85
|
|
|
HC TUBE ENDOTRACH 2.0MM UNCUFF
|
Facility
|
OP
|
$13.45
|
|
| Hospital Charge Code |
901698583
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.11 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.82
|
| Rate for Payer: Blue Shield of California Commercial |
$8.53
|
| Rate for Payer: Blue Shield of California EPN |
$5.37
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: Cigna of CA HMO |
$8.61
|
| Rate for Payer: Cigna of CA PPO |
$9.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.41
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.72
|
| Rate for Payer: United Healthcare All Other HMO |
$6.72
|
| Rate for Payer: United Healthcare HMO Rider |
$6.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC TUBE ENDOTRACH 2.0MM UNCUFF
|
Facility
|
IP
|
$13.45
|
|
| Hospital Charge Code |
901698583
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.11 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
IP
|
$32.64
|
|
| Hospital Charge Code |
901698934
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Adventist Health Commercial |
$6.53
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Senior |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$32.64
|
|
| Hospital Charge Code |
901698934
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Adventist Health Commercial |
$6.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Blue Shield of California Commercial |
$20.69
|
| Rate for Payer: Blue Shield of California EPN |
$13.02
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: Cigna of CA HMO |
$20.89
|
| Rate for Payer: Cigna of CA PPO |
$24.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Senior |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.85
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
| Rate for Payer: Riverside University Health System MISP |
$13.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.32
|
| Rate for Payer: United Healthcare All Other HMO |
$16.32
|
| Rate for Payer: United Healthcare HMO Rider |
$16.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.74
|
| Rate for Payer: Vantage Medical Group Senior |
$27.74
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$15.42
|
|
| Hospital Charge Code |
901698584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$13.88 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.97
|
| Rate for Payer: Blue Shield of California Commercial |
$9.78
|
| Rate for Payer: Blue Shield of California EPN |
$6.15
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Central Health Plan Commercial |
$12.34
|
| Rate for Payer: Cigna of CA HMO |
$9.87
|
| Rate for Payer: Cigna of CA PPO |
$11.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Senior |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$13.11
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.79
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.11
|
| Rate for Payer: Riverside University Health System MISP |
$6.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.71
|
| Rate for Payer: United Healthcare All Other HMO |
$7.71
|
| Rate for Payer: United Healthcare HMO Rider |
$7.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.11
|
| Rate for Payer: Vantage Medical Group Senior |
$13.11
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
IP
|
$15.42
|
|
| Hospital Charge Code |
901698584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$13.88 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Central Health Plan Commercial |
$12.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Senior |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$13.11
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.11
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.77 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$6.39
|
| Rate for Payer: Central Health Plan Commercial |
$11.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.84
|
| Rate for Payer: Multiplan Commercial |
$10.64
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.77 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.25
|
| Rate for Payer: Blue Shield of California Commercial |
$9.00
|
| Rate for Payer: Blue Shield of California EPN |
$5.66
|
| Rate for Payer: Cash Price |
$6.39
|
| Rate for Payer: Central Health Plan Commercial |
$11.35
|
| Rate for Payer: Cigna of CA HMO |
$9.08
|
| Rate for Payer: Cigna of CA PPO |
$10.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.93
|
| Rate for Payer: Multiplan Commercial |
$10.64
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
| Rate for Payer: Riverside University Health System MISP |
$5.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.09
|
| Rate for Payer: United Healthcare All Other HMO |
$7.09
|
| Rate for Payer: United Healthcare HMO Rider |
$7.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.06
|
| Rate for Payer: Vantage Medical Group Senior |
$12.06
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.77 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$6.39
|
| Rate for Payer: Central Health Plan Commercial |
$11.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.84
|
| Rate for Payer: Multiplan Commercial |
$10.64
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
OP
|
$56.74
|
|
| Hospital Charge Code |
901698930
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$51.07 |
| Rate for Payer: Adventist Health Commercial |
$11.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.01
|
| Rate for Payer: Blue Shield of California Commercial |
$35.97
|
| Rate for Payer: Blue Shield of California EPN |
$22.64
|
| Rate for Payer: Cash Price |
$25.53
|
| Rate for Payer: Central Health Plan Commercial |
$45.39
|
| Rate for Payer: Cigna of CA HMO |
$36.31
|
| Rate for Payer: Cigna of CA PPO |
$41.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.70
|
| Rate for Payer: EPIC Health Plan Senior |
$22.70
|
| Rate for Payer: Galaxy Health WC |
$48.23
|
| Rate for Payer: Global Benefits Group Commercial |
$34.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39.72
|
| Rate for Payer: Multiplan Commercial |
$42.55
|
| Rate for Payer: Networks By Design Commercial |
$36.88
|
| Rate for Payer: Prime Health Services Commercial |
$48.23
|
| Rate for Payer: Riverside University Health System MISP |
$22.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.37
|
| Rate for Payer: United Healthcare All Other HMO |
$28.37
|
| Rate for Payer: United Healthcare HMO Rider |
$28.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.23
|
| Rate for Payer: Vantage Medical Group Senior |
$48.23
|
|
