|
HC TRAY CATH SLCN 18FR URN MTR
|
Facility
IP
|
$117.12
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.42 |
| Max. Negotiated Rate |
$105.41 |
| Rate for Payer: Cash Price |
$52.70
|
| Rate for Payer: Central Health Plan Commercial |
$93.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.85
|
| Rate for Payer: Galaxy Health WC |
$99.55
|
| Rate for Payer: Global Benefits Group Commercial |
$70.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.42
|
| Rate for Payer: Multiplan Commercial |
$87.84
|
| Rate for Payer: Networks By Design Commercial |
$76.13
|
| Rate for Payer: Prime Health Services Commercial |
$99.55
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
OP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$84.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$54.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$54.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.00
|
| Rate for Payer: BCBS Transplant Transplant |
$59.92
|
| Rate for Payer: Blue Shield of California Commercial |
$62.81
|
| Rate for Payer: Blue Shield of California EPN |
$48.83
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Central Health Plan Commercial |
$79.89
|
| Rate for Payer: Cigna of CA HMO |
$63.91
|
| Rate for Payer: Cigna of CA PPO |
$73.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.87
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$74.90
|
| Rate for Payer: IEHP medi-cal |
$34.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.97
|
| Rate for Payer: Multiplan Commercial |
$74.90
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$59.92
|
| Rate for Payer: Riverside University Health MISP |
$39.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.93
|
| Rate for Payer: United Healthcare All Other HMO |
$49.93
|
| Rate for Payer: United Healthcare HMO Rider |
$49.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.88
|
| Rate for Payer: Vantage Medical Group Senior |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
IP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Central Health Plan Commercial |
$79.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.97
|
| Rate for Payer: Multiplan Commercial |
$74.90
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
OP
|
$105.03
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$89.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$57.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$57.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.05
|
| Rate for Payer: BCBS Transplant Transplant |
$63.02
|
| Rate for Payer: Blue Shield of California Commercial |
$66.06
|
| Rate for Payer: Blue Shield of California EPN |
$51.36
|
| Rate for Payer: Cash Price |
$47.26
|
| Rate for Payer: Central Health Plan Commercial |
$84.02
|
| Rate for Payer: Cigna of CA HMO |
$67.22
|
| Rate for Payer: Cigna of CA PPO |
$77.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.01
|
| Rate for Payer: Galaxy Health WC |
$89.28
|
| Rate for Payer: Global Benefits Group Commercial |
$63.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.53
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$78.77
|
| Rate for Payer: IEHP medi-cal |
$36.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.01
|
| Rate for Payer: Multiplan Commercial |
$78.77
|
| Rate for Payer: Networks By Design Commercial |
$68.27
|
| Rate for Payer: Prime Health Services Commercial |
$89.28
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$63.02
|
| Rate for Payer: Riverside University Health MISP |
$42.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.52
|
| Rate for Payer: United Healthcare All Other HMO |
$52.52
|
| Rate for Payer: United Healthcare HMO Rider |
$52.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.28
|
| Rate for Payer: Vantage Medical Group Senior |
$89.28
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
IP
|
$105.03
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Cash Price |
$47.26
|
| Rate for Payer: Central Health Plan Commercial |
$84.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: Galaxy Health WC |
$89.28
|
| Rate for Payer: Global Benefits Group Commercial |
$63.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.01
|
| Rate for Payer: Multiplan Commercial |
$78.77
|
| Rate for Payer: Networks By Design Commercial |
$68.27
|
| Rate for Payer: Prime Health Services Commercial |
$89.28
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
OP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$101.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$95.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$61.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$61.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.32
|
| Rate for Payer: BCBS Transplant Transplant |
$67.35
|
| Rate for Payer: Blue Shield of California Commercial |
$70.61
|
| Rate for Payer: Blue Shield of California EPN |
$54.89
|
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Central Health Plan Commercial |
$89.80
|
| Rate for Payer: Cigna of CA HMO |
$71.84
|
| Rate for Payer: Cigna of CA PPO |
$83.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$95.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$84.19
|
| Rate for Payer: IEHP medi-cal |
$39.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.45
|
| Rate for Payer: Multiplan Commercial |
$84.19
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$67.35
|
| Rate for Payer: Riverside University Health MISP |
$44.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.12
|
| Rate for Payer: United Healthcare All Other HMO |
$56.12
|
| Rate for Payer: United Healthcare HMO Rider |
$56.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$95.41
|
| Rate for Payer: Vantage Medical Group Senior |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
IP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$101.02 |
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Central Health Plan Commercial |
$89.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.45
|
| Rate for Payer: Multiplan Commercial |
$84.19
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
IP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Central Health Plan Commercial |
$95.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.82
|
| Rate for Payer: Multiplan Commercial |
$89.32
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
OP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$101.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$65.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.36
|
| Rate for Payer: BCBS Transplant Transplant |
$71.45
|
| Rate for Payer: Blue Shield of California Commercial |
$74.91
|
| Rate for Payer: Blue Shield of California EPN |
$58.24
|
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Central Health Plan Commercial |
$95.27
|
| Rate for Payer: Cigna of CA HMO |
$76.22
|
| Rate for Payer: Cigna of CA PPO |
$88.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$107.18
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$89.32
|
| Rate for Payer: IEHP medi-cal |
$41.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.82
|
| Rate for Payer: Multiplan Commercial |
$89.32
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$71.45
|
| Rate for Payer: Riverside University Health MISP |
$47.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.54
|
| Rate for Payer: United Healthcare All Other HMO |
$59.54
|
| Rate for Payer: United Healthcare HMO Rider |
$59.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.23
|
| Rate for Payer: Vantage Medical Group Senior |
$101.23
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
IP
|
$23.94
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Central Health Plan Commercial |
$19.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: Galaxy Health WC |
$20.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$17.96
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
OP
|
$23.94
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.14
|
| Rate for Payer: BCBS Transplant Transplant |
$14.36
|
| Rate for Payer: Blue Shield of California Commercial |
$15.06
|
| Rate for Payer: Blue Shield of California EPN |
$11.71
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Central Health Plan Commercial |
$19.15
|
| Rate for Payer: Cigna of CA HMO |
$15.32
|
| Rate for Payer: Cigna of CA PPO |
$17.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.58
|
| Rate for Payer: Galaxy Health WC |
$20.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.96
|
| Rate for Payer: IEHP medi-cal |
$8.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$17.96
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.36
|
| Rate for Payer: Riverside University Health MISP |
$9.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20.35
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
IP
|
$103.44
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$93.10 |
| Rate for Payer: Cash Price |
$46.55
|
| Rate for Payer: Central Health Plan Commercial |
$82.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.38
|
| Rate for Payer: Galaxy Health WC |
$87.92
|
| Rate for Payer: Global Benefits Group Commercial |
$62.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.69
|
| Rate for Payer: Multiplan Commercial |
$77.58
|
| Rate for Payer: Networks By Design Commercial |
$67.24
|
| Rate for Payer: Prime Health Services Commercial |
$87.92
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
OP
|
$103.44
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$93.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$87.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$56.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.11
|
| Rate for Payer: BCBS Transplant Transplant |
$62.06
|
| Rate for Payer: Blue Shield of California Commercial |
$65.06
|
| Rate for Payer: Blue Shield of California EPN |
$50.58
|
| Rate for Payer: Cash Price |
$46.55
|
| Rate for Payer: Central Health Plan Commercial |
$82.75
|
| Rate for Payer: Cigna of CA HMO |
$66.20
|
| Rate for Payer: Cigna of CA PPO |
$76.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$41.38
|
| Rate for Payer: Galaxy Health WC |
$87.92
|
| Rate for Payer: Global Benefits Group Commercial |
$62.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$77.58
|
| Rate for Payer: IEHP medi-cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.69
|
| Rate for Payer: Multiplan Commercial |
$77.58
|
| Rate for Payer: Networks By Design Commercial |
$67.24
|
| Rate for Payer: Prime Health Services Commercial |
$87.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$62.06
|
| Rate for Payer: Riverside University Health MISP |
$41.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.72
|
| Rate for Payer: United Healthcare All Other HMO |
$51.72
|
| Rate for Payer: United Healthcare HMO Rider |
$51.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.92
|
| Rate for Payer: Vantage Medical Group Senior |
$87.92
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
OP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$20.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.60
|
| Rate for Payer: BCBS Transplant Transplant |
$7.72
|
| Rate for Payer: Blue Shield of California Commercial |
$8.10
|
| Rate for Payer: Blue Shield of California EPN |
$6.29
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.65
|
| Rate for Payer: IEHP medi-cal |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: Riverside University Health MISP |
$5.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.44
|
| Rate for Payer: United Healthcare All Other HMO |
$6.44
|
| Rate for Payer: United Healthcare HMO Rider |
$6.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
IP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
OP
|
$21.24
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$20.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.55
|
| Rate for Payer: BCBS Transplant Transplant |
$12.74
|
| Rate for Payer: Blue Shield of California Commercial |
$13.36
|
| Rate for Payer: Blue Shield of California EPN |
$10.39
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.93
|
| Rate for Payer: IEHP medi-cal |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: Riverside University Health MISP |
$8.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
IP
|
$21.24
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
|
HC TRAY FOLEY INS W 30ML SYR PVP
|
Facility
IP
|
$15.09
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901607398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$13.58 |
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Central Health Plan Commercial |
$12.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.04
|
| Rate for Payer: Galaxy Health WC |
$12.83
|
| Rate for Payer: Global Benefits Group Commercial |
$9.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$11.32
|
| Rate for Payer: Networks By Design Commercial |
$9.81
|
| Rate for Payer: Prime Health Services Commercial |
$12.83
|
|
|
HC TRAY FOLEY INS W 30ML SYR PVP
|
Facility
OP
|
$15.09
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901607398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$32.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.92
|
| Rate for Payer: BCBS Transplant Transplant |
$9.05
|
| Rate for Payer: Blue Shield of California Commercial |
$9.49
|
| Rate for Payer: Blue Shield of California EPN |
$7.38
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Central Health Plan Commercial |
$12.07
|
| Rate for Payer: Cigna of CA HMO |
$9.66
|
| Rate for Payer: Cigna of CA PPO |
$11.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.04
|
| Rate for Payer: Galaxy Health WC |
$12.83
|
| Rate for Payer: Global Benefits Group Commercial |
$9.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.32
|
| Rate for Payer: IEHP medi-cal |
$5.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$11.32
|
| Rate for Payer: Networks By Design Commercial |
$9.81
|
| Rate for Payer: Prime Health Services Commercial |
$12.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.05
|
| Rate for Payer: Riverside University Health MISP |
$6.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.54
|
| Rate for Payer: United Healthcare All Other HMO |
$7.54
|
| Rate for Payer: United Healthcare HMO Rider |
$7.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.83
|
| Rate for Payer: Vantage Medical Group Senior |
$12.83
|
|
|
HC TRAY FOLEY URN MTR NO CATH
|
Facility
OP
|
$113.24
|
|
|
Service Code
|
CPT A4354
|
| Hospital Charge Code |
901698796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.65 |
| Max. Negotiated Rate |
$101.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.99
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$96.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$62.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.90
|
| Rate for Payer: BCBS Transplant Transplant |
$67.94
|
| Rate for Payer: Blue Shield of California Commercial |
$71.23
|
| Rate for Payer: Blue Shield of California EPN |
$55.37
|
| Rate for Payer: Cash Price |
$50.96
|
| Rate for Payer: Cash Price |
$50.96
|
| Rate for Payer: Central Health Plan Commercial |
$90.59
|
| Rate for Payer: Cigna of CA HMO |
$72.47
|
| Rate for Payer: Cigna of CA PPO |
$83.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.30
|
| Rate for Payer: Galaxy Health WC |
$96.25
|
| Rate for Payer: Global Benefits Group Commercial |
$67.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.92
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$84.93
|
| Rate for Payer: IEHP medi-cal |
$39.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.65
|
| Rate for Payer: Multiplan Commercial |
$84.93
|
| Rate for Payer: Networks By Design Commercial |
$73.61
|
| Rate for Payer: Prime Health Services Commercial |
$96.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$67.94
|
| Rate for Payer: Riverside University Health MISP |
$45.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.62
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$56.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.25
|
| Rate for Payer: Vantage Medical Group Senior |
$96.25
|
|
|
HC TRAY FOLEY URN MTR NO CATH
|
Facility
IP
|
$113.24
|
|
|
Service Code
|
CPT A4354
|
| Hospital Charge Code |
901698796
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.65 |
| Max. Negotiated Rate |
$101.92 |
| Rate for Payer: Cash Price |
$50.96
|
| Rate for Payer: Central Health Plan Commercial |
$90.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.30
|
| Rate for Payer: Galaxy Health WC |
$96.25
|
| Rate for Payer: Global Benefits Group Commercial |
$67.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.65
|
| Rate for Payer: Multiplan Commercial |
$84.93
|
| Rate for Payer: Networks By Design Commercial |
$73.61
|
| Rate for Payer: Prime Health Services Commercial |
$96.25
|
|
|
HC TRAY LEADER FLEX INSERTION
|
Facility
OP
|
$4.42
|
|
| Hospital Charge Code |
901698221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.61
|
| Rate for Payer: BCBS Transplant Transplant |
$2.65
|
| Rate for Payer: Blue Shield of California Commercial |
$2.78
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: Cigna of CA HMO |
$2.83
|
| Rate for Payer: Cigna of CA PPO |
$3.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.76
|
| Rate for Payer: Global Benefits Group Commercial |
$2.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.98
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.32
|
| Rate for Payer: IEHP medi-cal |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.88
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.87
|
| Rate for Payer: Prime Health Services Commercial |
$3.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.65
|
| Rate for Payer: Riverside University Health MISP |
$1.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.21
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare HMO Rider |
$2.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.76
|
| Rate for Payer: Vantage Medical Group Senior |
$3.76
|
|
|
HC TRAY LEADER FLEX INSERTION
|
Facility
IP
|
$4.42
|
|
| Hospital Charge Code |
901698221
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.76
|
| Rate for Payer: Global Benefits Group Commercial |
$2.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.88
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.87
|
| Rate for Payer: Prime Health Services Commercial |
$3.76
|
|
|
HC TRAY NICU PICC
|
Facility
OP
|
$5.74
|
|
| Hospital Charge Code |
901698414
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.39
|
| Rate for Payer: BCBS Transplant Transplant |
$3.44
|
| Rate for Payer: Blue Shield of California Commercial |
$3.61
|
| Rate for Payer: Blue Shield of California EPN |
$2.81
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Central Health Plan Commercial |
$4.59
|
| Rate for Payer: Cigna of CA HMO |
$3.67
|
| Rate for Payer: Cigna of CA PPO |
$4.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.30
|
| Rate for Payer: Galaxy Health WC |
$4.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.17
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.30
|
| Rate for Payer: IEHP medi-cal |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.44
|
| Rate for Payer: Riverside University Health MISP |
$2.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.87
|
| Rate for Payer: United Healthcare All Other HMO |
$2.87
|
| Rate for Payer: United Healthcare HMO Rider |
$2.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4.88
|
|
|
HC TRAY NICU PICC
|
Facility
IP
|
$5.74
|
|
| Hospital Charge Code |
901698414
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Central Health Plan Commercial |
$4.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.30
|
| Rate for Payer: Galaxy Health WC |
$4.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.88
|
|
