|
HC TUBE ESOPHAGEAL ADULT
|
Facility
|
OP
|
$2,022.94
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.02 |
| Max. Negotiated Rate |
$1,820.65 |
| Rate for Payer: Adventist Health Commercial |
$404.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,719.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,112.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,517.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$979.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,176.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,282.54
|
| Rate for Payer: Blue Shield of California EPN |
$807.15
|
| Rate for Payer: Cash Price |
$910.32
|
| Rate for Payer: Cash Price |
$910.32
|
| Rate for Payer: Central Health Plan Commercial |
$1,618.35
|
| Rate for Payer: Cigna of CA HMO |
$1,294.68
|
| Rate for Payer: Cigna of CA PPO |
$1,496.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,719.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,719.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,719.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,416.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$809.18
|
| Rate for Payer: EPIC Health Plan Senior |
$809.18
|
| Rate for Payer: Galaxy Health WC |
$1,719.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,820.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,284.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$734.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$404.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,416.06
|
| Rate for Payer: Multiplan Commercial |
$1,517.20
|
| Rate for Payer: Networks By Design Commercial |
$1,314.91
|
| Rate for Payer: Prime Health Services Commercial |
$1,719.50
|
| Rate for Payer: Riverside University Health System MISP |
$809.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,213.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,213.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,011.47
|
| Rate for Payer: United Healthcare All Other HMO |
$1,011.47
|
| Rate for Payer: United Healthcare HMO Rider |
$1,011.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,011.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,719.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,719.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,719.50
|
|
|
HC TUBE ESOPHAGEAL ADULT
|
Facility
|
IP
|
$2,022.94
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.59 |
| Max. Negotiated Rate |
$1,820.65 |
| Rate for Payer: Adventist Health Commercial |
$404.59
|
| Rate for Payer: Cash Price |
$910.32
|
| Rate for Payer: Central Health Plan Commercial |
$1,618.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,416.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$809.18
|
| Rate for Payer: EPIC Health Plan Senior |
$809.18
|
| Rate for Payer: Galaxy Health WC |
$1,719.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,213.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,820.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,284.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,193.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$404.59
|
| Rate for Payer: Multiplan Commercial |
$1,517.20
|
| Rate for Payer: Networks By Design Commercial |
$1,314.91
|
| Rate for Payer: Prime Health Services Commercial |
$1,719.50
|
|
|
HC TUBE FEEDING 10FR, 43CM ENF
|
Facility
|
IP
|
$1,157.73
|
|
| Hospital Charge Code |
901698438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.55 |
| Max. Negotiated Rate |
$1,041.96 |
| Rate for Payer: Adventist Health Commercial |
$231.55
|
| Rate for Payer: Cash Price |
$520.98
|
| Rate for Payer: Central Health Plan Commercial |
$926.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.09
|
| Rate for Payer: EPIC Health Plan Senior |
$463.09
|
| Rate for Payer: Galaxy Health WC |
$984.07
|
| Rate for Payer: Global Benefits Group Commercial |
$694.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,041.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.55
|
| Rate for Payer: Multiplan Commercial |
$868.30
|
| Rate for Payer: Networks By Design Commercial |
$752.52
|
| Rate for Payer: Prime Health Services Commercial |
$984.07
|
|
|
HC TUBE FEEDING 10FR, 43CM ENF
|
Facility
|
OP
|
$1,157.73
|
|
| Hospital Charge Code |
901698438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.55 |
| Max. Negotiated Rate |
$1,041.96 |
| Rate for Payer: Adventist Health Commercial |
$231.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$703.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$984.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$636.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$868.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$560.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$673.45
|
| Rate for Payer: Blue Shield of California Commercial |
$734.00
|
| Rate for Payer: Blue Shield of California EPN |
$461.93
|
| Rate for Payer: Cash Price |
$520.98
|
| Rate for Payer: Central Health Plan Commercial |
$926.18
|
| Rate for Payer: Cigna of CA HMO |
$740.95
|
| Rate for Payer: Cigna of CA PPO |
$856.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$984.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$984.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$984.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.09
|
| Rate for Payer: EPIC Health Plan Senior |
$463.09
|
| Rate for Payer: Galaxy Health WC |
$984.07
|
| Rate for Payer: Global Benefits Group Commercial |
$694.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,041.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$420.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$810.41
|
| Rate for Payer: Multiplan Commercial |
$868.30
|
| Rate for Payer: Networks By Design Commercial |
$752.52
|
| Rate for Payer: Prime Health Services Commercial |
$984.07
|
| Rate for Payer: Riverside University Health System MISP |
$463.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$694.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$694.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.87
|
| Rate for Payer: United Healthcare All Other HMO |
$578.87
|
| Rate for Payer: United Healthcare HMO Rider |
$578.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$578.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$984.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$984.07
|
| Rate for Payer: Vantage Medical Group Senior |
$984.07
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PORT
|
Facility
|
OP
|
$54.53
|
|
| Hospital Charge Code |
901698222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.91 |
| Max. Negotiated Rate |
$49.08 |
| Rate for Payer: Adventist Health Commercial |
$10.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.72
|
| Rate for Payer: Blue Shield of California Commercial |
$34.57
|
| Rate for Payer: Blue Shield of California EPN |
$21.76
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Central Health Plan Commercial |
$43.62
|
| Rate for Payer: Cigna of CA HMO |
$34.90
|
| Rate for Payer: Cigna of CA PPO |
$40.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$46.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.81
|
| Rate for Payer: EPIC Health Plan Senior |
$21.81
|
| Rate for Payer: Galaxy Health WC |
$46.35
|
| Rate for Payer: Global Benefits Group Commercial |
$32.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$38.17
|
| Rate for Payer: Multiplan Commercial |
$40.90
|
| Rate for Payer: Networks By Design Commercial |
$35.44
|
| Rate for Payer: Prime Health Services Commercial |
$46.35
|
| Rate for Payer: Riverside University Health System MISP |
$21.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.27
|
| Rate for Payer: United Healthcare All Other HMO |
$27.27
|
| Rate for Payer: United Healthcare HMO Rider |
$27.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.35
|
| Rate for Payer: Vantage Medical Group Senior |
$46.35
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PORT
|
Facility
|
IP
|
$54.53
|
|
| Hospital Charge Code |
901698222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.91 |
| Max. Negotiated Rate |
$49.08 |
| Rate for Payer: Adventist Health Commercial |
$10.91
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Central Health Plan Commercial |
$43.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.81
|
| Rate for Payer: EPIC Health Plan Senior |
$21.81
|
| Rate for Payer: Galaxy Health WC |
$46.35
|
| Rate for Payer: Global Benefits Group Commercial |
$32.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$40.90
|
| Rate for Payer: Networks By Design Commercial |
$35.44
|
| Rate for Payer: Prime Health Services Commercial |
$46.35
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PRT
|
Facility
|
OP
|
$58.38
|
|
| Hospital Charge Code |
901606359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.68 |
| Max. Negotiated Rate |
$52.54 |
| Rate for Payer: Adventist Health Commercial |
$11.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.96
|
| Rate for Payer: Blue Shield of California Commercial |
$37.01
|
| Rate for Payer: Blue Shield of California EPN |
$23.29
|
| Rate for Payer: Cash Price |
$26.27
|
| Rate for Payer: Central Health Plan Commercial |
$46.70
|
| Rate for Payer: Cigna of CA HMO |
$37.36
|
| Rate for Payer: Cigna of CA PPO |
$43.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.35
|
| Rate for Payer: EPIC Health Plan Senior |
$23.35
|
| Rate for Payer: Galaxy Health WC |
$49.62
|
| Rate for Payer: Global Benefits Group Commercial |
$35.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$40.87
|
| Rate for Payer: Multiplan Commercial |
$43.78
|
| Rate for Payer: Networks By Design Commercial |
$37.95
|
| Rate for Payer: Prime Health Services Commercial |
$49.62
|
| Rate for Payer: Riverside University Health System MISP |
$23.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.19
|
| Rate for Payer: United Healthcare All Other HMO |
$29.19
|
| Rate for Payer: United Healthcare HMO Rider |
$29.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.62
|
| Rate for Payer: Vantage Medical Group Senior |
$49.62
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PRT
|
Facility
|
IP
|
$58.38
|
|
| Hospital Charge Code |
901606359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.68 |
| Max. Negotiated Rate |
$52.54 |
| Rate for Payer: Adventist Health Commercial |
$11.68
|
| Rate for Payer: Cash Price |
$26.27
|
| Rate for Payer: Central Health Plan Commercial |
$46.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.35
|
| Rate for Payer: EPIC Health Plan Senior |
$23.35
|
| Rate for Payer: Galaxy Health WC |
$49.62
|
| Rate for Payer: Global Benefits Group Commercial |
$35.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.68
|
| Rate for Payer: Multiplan Commercial |
$43.78
|
| Rate for Payer: Networks By Design Commercial |
$37.95
|
| Rate for Payer: Prime Health Services Commercial |
$49.62
|
|
|
HC TUBE FEEDING 12FR, 43CM ENF
|
Facility
|
IP
|
$1,157.73
|
|
| Hospital Charge Code |
901698437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.55 |
| Max. Negotiated Rate |
$1,041.96 |
| Rate for Payer: Adventist Health Commercial |
$231.55
|
| Rate for Payer: Cash Price |
$520.98
|
| Rate for Payer: Central Health Plan Commercial |
$926.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.09
|
| Rate for Payer: EPIC Health Plan Senior |
$463.09
|
| Rate for Payer: Galaxy Health WC |
$984.07
|
| Rate for Payer: Global Benefits Group Commercial |
$694.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,041.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.55
|
| Rate for Payer: Multiplan Commercial |
$868.30
|
| Rate for Payer: Networks By Design Commercial |
$752.52
|
| Rate for Payer: Prime Health Services Commercial |
$984.07
|
|
|
HC TUBE FEEDING 12FR, 43CM ENF
|
Facility
|
OP
|
$1,157.73
|
|
| Hospital Charge Code |
901698437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.55 |
| Max. Negotiated Rate |
$1,041.96 |
| Rate for Payer: Adventist Health Commercial |
$231.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$703.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$984.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$636.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$868.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$560.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$673.45
|
| Rate for Payer: Blue Shield of California Commercial |
$734.00
|
| Rate for Payer: Blue Shield of California EPN |
$461.93
|
| Rate for Payer: Cash Price |
$520.98
|
| Rate for Payer: Central Health Plan Commercial |
$926.18
|
| Rate for Payer: Cigna of CA HMO |
$740.95
|
| Rate for Payer: Cigna of CA PPO |
$856.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$984.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$984.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$984.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$810.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$463.09
|
| Rate for Payer: EPIC Health Plan Senior |
$463.09
|
| Rate for Payer: Galaxy Health WC |
$984.07
|
| Rate for Payer: Global Benefits Group Commercial |
$694.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,041.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$735.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$420.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$683.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$810.41
|
| Rate for Payer: Multiplan Commercial |
$868.30
|
| Rate for Payer: Networks By Design Commercial |
$752.52
|
| Rate for Payer: Prime Health Services Commercial |
$984.07
|
| Rate for Payer: Riverside University Health System MISP |
$463.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$694.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$694.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.87
|
| Rate for Payer: United Healthcare All Other HMO |
$578.87
|
| Rate for Payer: United Healthcare HMO Rider |
$578.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$578.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$984.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$984.07
|
| Rate for Payer: Vantage Medical Group Senior |
$984.07
|
|
|
HC TUBE FEEDING 5FR 22" W/STYLET
|
Facility
|
IP
|
$114.61
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$103.15 |
| Rate for Payer: Adventist Health Commercial |
$22.92
|
| Rate for Payer: Cash Price |
$51.57
|
| Rate for Payer: Central Health Plan Commercial |
$91.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.84
|
| Rate for Payer: EPIC Health Plan Senior |
$45.84
|
| Rate for Payer: Galaxy Health WC |
$97.42
|
| Rate for Payer: Global Benefits Group Commercial |
$68.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.92
|
| Rate for Payer: Multiplan Commercial |
$85.96
|
| Rate for Payer: Networks By Design Commercial |
$74.50
|
| Rate for Payer: Prime Health Services Commercial |
$97.42
|
|
|
HC TUBE FEEDING 5FR 22" W/STYLET
|
Facility
|
OP
|
$114.61
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$103.15 |
| Rate for Payer: Adventist Health Commercial |
$22.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$97.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.67
|
| Rate for Payer: Blue Shield of California Commercial |
$72.66
|
| Rate for Payer: Blue Shield of California EPN |
$45.73
|
| Rate for Payer: Cash Price |
$51.57
|
| Rate for Payer: Cash Price |
$51.57
|
| Rate for Payer: Central Health Plan Commercial |
$91.69
|
| Rate for Payer: Cigna of CA HMO |
$73.35
|
| Rate for Payer: Cigna of CA PPO |
$84.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$97.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$97.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.84
|
| Rate for Payer: EPIC Health Plan Senior |
$45.84
|
| Rate for Payer: Galaxy Health WC |
$97.42
|
| Rate for Payer: Global Benefits Group Commercial |
$68.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$80.23
|
| Rate for Payer: Multiplan Commercial |
$85.96
|
| Rate for Payer: Networks By Design Commercial |
$74.50
|
| Rate for Payer: Prime Health Services Commercial |
$97.42
|
| Rate for Payer: Riverside University Health System MISP |
$45.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.30
|
| Rate for Payer: United Healthcare All Other HMO |
$57.30
|
| Rate for Payer: United Healthcare HMO Rider |
$57.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$97.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.42
|
| Rate for Payer: Vantage Medical Group Senior |
$97.42
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
IP
|
$120.46
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$108.41 |
| Rate for Payer: Adventist Health Commercial |
$24.09
|
| Rate for Payer: Cash Price |
$54.21
|
| Rate for Payer: Central Health Plan Commercial |
$96.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.18
|
| Rate for Payer: EPIC Health Plan Senior |
$48.18
|
| Rate for Payer: Galaxy Health WC |
$102.39
|
| Rate for Payer: Global Benefits Group Commercial |
$72.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.09
|
| Rate for Payer: Multiplan Commercial |
$90.34
|
| Rate for Payer: Networks By Design Commercial |
$78.30
|
| Rate for Payer: Prime Health Services Commercial |
$102.39
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
OP
|
$120.46
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$108.41 |
| Rate for Payer: Adventist Health Commercial |
$24.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.07
|
| Rate for Payer: Blue Shield of California Commercial |
$76.37
|
| Rate for Payer: Blue Shield of California EPN |
$48.06
|
| Rate for Payer: Cash Price |
$54.21
|
| Rate for Payer: Cash Price |
$54.21
|
| Rate for Payer: Central Health Plan Commercial |
$96.37
|
| Rate for Payer: Cigna of CA HMO |
$77.09
|
| Rate for Payer: Cigna of CA PPO |
$89.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.18
|
| Rate for Payer: EPIC Health Plan Senior |
$48.18
|
| Rate for Payer: Galaxy Health WC |
$102.39
|
| Rate for Payer: Global Benefits Group Commercial |
$72.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$84.32
|
| Rate for Payer: Multiplan Commercial |
$90.34
|
| Rate for Payer: Networks By Design Commercial |
$78.30
|
| Rate for Payer: Prime Health Services Commercial |
$102.39
|
| Rate for Payer: Riverside University Health System MISP |
$48.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.23
|
| Rate for Payer: United Healthcare All Other HMO |
$60.23
|
| Rate for Payer: United Healthcare HMO Rider |
$60.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.39
|
| Rate for Payer: Vantage Medical Group Senior |
$102.39
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
IP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
OP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.97
|
| Rate for Payer: Blue Shield of California Commercial |
$64.27
|
| Rate for Payer: Blue Shield of California EPN |
$40.45
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Cigna of CA HMO |
$64.88
|
| Rate for Payer: Cigna of CA PPO |
$75.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.97
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
| Rate for Payer: Riverside University Health System MISP |
$40.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.69
|
| Rate for Payer: United Healthcare All Other HMO |
$50.69
|
| Rate for Payer: United Healthcare HMO Rider |
$50.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.17
|
| Rate for Payer: Vantage Medical Group Senior |
$86.17
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
IP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
OP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.97
|
| Rate for Payer: Blue Shield of California Commercial |
$64.27
|
| Rate for Payer: Blue Shield of California EPN |
$40.45
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Cash Price |
$45.62
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Cigna of CA HMO |
$64.88
|
| Rate for Payer: Cigna of CA PPO |
$75.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$70.97
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
| Rate for Payer: Riverside University Health System MISP |
$40.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.69
|
| Rate for Payer: United Healthcare All Other HMO |
$50.69
|
| Rate for Payer: United Healthcare HMO Rider |
$50.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.17
|
| Rate for Payer: Vantage Medical Group Senior |
$86.17
|
|
|
HC TUBE FEEDING 8FR W/O STYLET
|
Facility
|
OP
|
$32.80
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$47.80 |
| Rate for Payer: Adventist Health Commercial |
$6.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.08
|
| Rate for Payer: Blue Shield of California Commercial |
$20.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.09
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: Cigna of CA HMO |
$20.99
|
| Rate for Payer: Cigna of CA PPO |
$24.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Senior |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.96
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
| Rate for Payer: Riverside University Health System MISP |
$13.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.40
|
| Rate for Payer: United Healthcare All Other HMO |
$16.40
|
| Rate for Payer: United Healthcare HMO Rider |
$16.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.88
|
| Rate for Payer: Vantage Medical Group Senior |
$27.88
|
|
|
HC TUBE FEEDING 8FR W/O STYLET
|
Facility
|
IP
|
$32.80
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$29.52 |
| Rate for Payer: Adventist Health Commercial |
$6.56
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Senior |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| 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: Health Management Network EPO/PPO |
$73.80
|
| 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 |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| 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 Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| 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: Health Management Network EPO/PPO |
$73.80
|
| 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 |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| 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 TUBE FEEDING ARGYLE 6.5FR, 16"
|
Facility
|
IP
|
$12.63
|
|
| Hospital Charge Code |
901607668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Adventist Health Commercial |
$2.53
|
| Rate for Payer: Cash Price |
$5.68
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
|
|
HC TUBE FEEDING ARGYLE 6.5FR, 16"
|
Facility
|
OP
|
$12.63
|
|
| Hospital Charge Code |
901607668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Adventist Health Commercial |
$2.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.35
|
| Rate for Payer: Blue Shield of California Commercial |
$8.01
|
| Rate for Payer: Blue Shield of California EPN |
$5.04
|
| Rate for Payer: Cash Price |
$5.68
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: Cigna of CA HMO |
$8.08
|
| Rate for Payer: Cigna of CA PPO |
$9.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.84
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.32
|
| Rate for Payer: United Healthcare All Other HMO |
$6.32
|
| Rate for Payer: United Healthcare HMO Rider |
$6.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC TUBE FEEDING ARGYLE 8FR, 16"
|
Facility
|
OP
|
$144.48
|
|
| Hospital Charge Code |
901607669
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.90 |
| Max. Negotiated Rate |
$130.03 |
| Rate for Payer: Adventist Health Commercial |
$28.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$122.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$79.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.04
|
| Rate for Payer: Blue Shield of California Commercial |
$91.60
|
| Rate for Payer: Blue Shield of California EPN |
$57.65
|
| Rate for Payer: Cash Price |
$65.02
|
| Rate for Payer: Central Health Plan Commercial |
$115.58
|
| Rate for Payer: Cigna of CA HMO |
$92.47
|
| Rate for Payer: Cigna of CA PPO |
$106.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$122.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$122.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$101.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.79
|
| Rate for Payer: EPIC Health Plan Senior |
$57.79
|
| Rate for Payer: Galaxy Health WC |
$122.81
|
| Rate for Payer: Global Benefits Group Commercial |
$86.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$91.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$85.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.14
|
| Rate for Payer: Multiplan Commercial |
$108.36
|
| Rate for Payer: Networks By Design Commercial |
$93.91
|
| Rate for Payer: Prime Health Services Commercial |
$122.81
|
| Rate for Payer: Riverside University Health System MISP |
$57.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.24
|
| Rate for Payer: United Healthcare All Other HMO |
$72.24
|
| Rate for Payer: United Healthcare HMO Rider |
$72.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$122.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$122.81
|
| Rate for Payer: Vantage Medical Group Senior |
$122.81
|
|
