|
HC TUBE ENDOTRACH FSTNR 5.0-8.0MM
|
Facility
|
IP
|
$83.45
|
|
| Hospital Charge Code |
901698364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.69 |
| Max. Negotiated Rate |
$75.10 |
| Rate for Payer: Cash Price |
$37.55
|
| Rate for Payer: Central Health Plan Commercial |
$66.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.38
|
| Rate for Payer: Galaxy Health WC |
$70.93
|
| Rate for Payer: Global Benefits Group Commercial |
$50.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.69
|
| Rate for Payer: Multiplan Commercial |
$62.59
|
| Rate for Payer: Networks By Design Commercial |
$54.24
|
| Rate for Payer: Prime Health Services Commercial |
$70.93
|
|
|
HC TUBE ENDOTRACH FSTNR 5.0-8.0MM
|
Facility
|
OP
|
$83.45
|
|
| Hospital Charge Code |
901698364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.69 |
| Max. Negotiated Rate |
$75.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$70.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.30
|
| Rate for Payer: Blue Distinction Transplant |
$50.07
|
| Rate for Payer: Blue Shield of California Commercial |
$52.49
|
| Rate for Payer: Blue Shield of California EPN |
$40.81
|
| Rate for Payer: Cash Price |
$37.55
|
| Rate for Payer: Central Health Plan Commercial |
$66.76
|
| Rate for Payer: Cigna of CA HMO |
$53.41
|
| Rate for Payer: Cigna of CA PPO |
$61.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$70.93
|
| Rate for Payer: Dignity Health Media |
$70.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.38
|
| Rate for Payer: Galaxy Health WC |
$70.93
|
| Rate for Payer: Global Benefits Group Commercial |
$50.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$62.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.69
|
| Rate for Payer: Multiplan Commercial |
$62.59
|
| Rate for Payer: Networks By Design Commercial |
$54.24
|
| Rate for Payer: Prime Health Services Commercial |
$70.93
|
| Rate for Payer: Riverside University Health System MISP |
$33.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.72
|
| Rate for Payer: United Healthcare All Other HMO |
$41.72
|
| Rate for Payer: United Healthcare HMO Rider |
$41.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.93
|
| Rate for Payer: Vantage Medical Group Senior |
$70.93
|
|
|
HC TUBE ENDOTRACH W/CUFF 6.5MM
|
Facility
|
OP
|
$266.98
|
|
| Hospital Charge Code |
901698707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.40 |
| Max. Negotiated Rate |
$240.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$162.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$226.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$146.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$146.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.73
|
| Rate for Payer: Blue Distinction Transplant |
$160.19
|
| Rate for Payer: Blue Shield of California Commercial |
$167.93
|
| Rate for Payer: Blue Shield of California EPN |
$130.55
|
| Rate for Payer: Cash Price |
$120.14
|
| Rate for Payer: Central Health Plan Commercial |
$213.58
|
| Rate for Payer: Cigna of CA HMO |
$170.87
|
| Rate for Payer: Cigna of CA PPO |
$197.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$226.93
|
| Rate for Payer: Dignity Health Media |
$226.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$226.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.79
|
| Rate for Payer: Galaxy Health WC |
$226.93
|
| Rate for Payer: Global Benefits Group Commercial |
$160.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.28
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$200.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$93.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$200.24
|
| Rate for Payer: Networks By Design Commercial |
$173.54
|
| Rate for Payer: Prime Health Services Commercial |
$226.93
|
| Rate for Payer: Riverside University Health System MISP |
$106.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$133.49
|
| Rate for Payer: United Healthcare All Other HMO |
$133.49
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$133.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$226.93
|
| Rate for Payer: Vantage Medical Group Senior |
$226.93
|
|
|
HC TUBE ENDOTRACH W/CUFF 6.5MM
|
Facility
|
IP
|
$266.98
|
|
| Hospital Charge Code |
901698707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.40 |
| Max. Negotiated Rate |
$240.28 |
| Rate for Payer: Cash Price |
$120.14
|
| Rate for Payer: Central Health Plan Commercial |
$213.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.79
|
| Rate for Payer: Galaxy Health WC |
$226.93
|
| Rate for Payer: Global Benefits Group Commercial |
$160.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$200.24
|
| Rate for Payer: Networks By Design Commercial |
$173.54
|
| Rate for Payer: Prime Health Services Commercial |
$226.93
|
|
|
HC TUBE ESOPHAGEAL ADULT
|
Facility
|
IP
|
$1,707.84
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$341.57 |
| Max. Negotiated Rate |
$1,537.06 |
| Rate for Payer: Cash Price |
$768.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,366.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$683.14
|
| Rate for Payer: Galaxy Health WC |
$1,451.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,024.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,537.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,139.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$650.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.57
|
| Rate for Payer: Multiplan Commercial |
$1,280.88
|
| Rate for Payer: Networks By Design Commercial |
$1,110.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,451.66
|
|
|
HC TUBE ESOPHAGEAL ADULT
|
Facility
|
OP
|
$1,707.84
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.79 |
| Max. Negotiated Rate |
$1,537.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,451.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$939.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$939.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$826.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,008.99
|
| Rate for Payer: Blue Distinction Transplant |
$1,024.70
|
| Rate for Payer: Blue Shield of California Commercial |
$1,074.23
|
| Rate for Payer: Blue Shield of California EPN |
$835.13
|
| Rate for Payer: Cash Price |
$768.53
|
| Rate for Payer: Cash Price |
$768.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,366.27
|
| Rate for Payer: Cigna of CA HMO |
$1,093.02
|
| Rate for Payer: Cigna of CA PPO |
$1,263.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,451.66
|
| Rate for Payer: Dignity Health Media |
$1,451.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,451.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$683.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$683.14
|
| Rate for Payer: Galaxy Health WC |
$1,451.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,024.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,537.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,280.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$597.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,139.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$650.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.57
|
| Rate for Payer: Multiplan Commercial |
$1,280.88
|
| Rate for Payer: Networks By Design Commercial |
$1,110.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,451.66
|
| Rate for Payer: Riverside University Health System MISP |
$683.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,024.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,024.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$853.92
|
| Rate for Payer: United Healthcare All Other HMO |
$853.92
|
| Rate for Payer: United Healthcare HMO Rider |
$853.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$853.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,451.66
|
| Rate for Payer: Vantage Medical Group Senior |
$1,451.66
|
|
|
HC TUBE FEEDING 10FR, 43CM ENF
|
Facility
|
IP
|
$829.66
|
|
| Hospital Charge Code |
901698438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$746.69 |
| Rate for Payer: Cash Price |
$373.35
|
| Rate for Payer: Central Health Plan Commercial |
$663.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.86
|
| Rate for Payer: Galaxy Health WC |
$705.21
|
| Rate for Payer: Global Benefits Group Commercial |
$497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.93
|
| Rate for Payer: Multiplan Commercial |
$622.24
|
| Rate for Payer: Networks By Design Commercial |
$539.28
|
| Rate for Payer: Prime Health Services Commercial |
$705.21
|
|
|
HC TUBE FEEDING 10FR, 43CM ENF
|
Facility
|
OP
|
$829.66
|
|
| Hospital Charge Code |
901698438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$746.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$503.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$705.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$456.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$401.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.16
|
| Rate for Payer: Blue Distinction Transplant |
$497.80
|
| Rate for Payer: Blue Shield of California Commercial |
$521.86
|
| Rate for Payer: Blue Shield of California EPN |
$405.70
|
| Rate for Payer: Cash Price |
$373.35
|
| Rate for Payer: Central Health Plan Commercial |
$663.73
|
| Rate for Payer: Cigna of CA HMO |
$530.98
|
| Rate for Payer: Cigna of CA PPO |
$613.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$705.21
|
| Rate for Payer: Dignity Health Media |
$705.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$705.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$331.86
|
| Rate for Payer: Galaxy Health WC |
$705.21
|
| Rate for Payer: Global Benefits Group Commercial |
$497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.69
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$622.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.93
|
| Rate for Payer: Multiplan Commercial |
$622.24
|
| Rate for Payer: Networks By Design Commercial |
$539.28
|
| Rate for Payer: Prime Health Services Commercial |
$705.21
|
| Rate for Payer: Riverside University Health System MISP |
$331.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$497.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$497.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$414.83
|
| Rate for Payer: United Healthcare All Other HMO |
$414.83
|
| Rate for Payer: United Healthcare HMO Rider |
$414.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$414.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$705.21
|
| Rate for Payer: Vantage Medical Group Senior |
$705.21
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PORT
|
Facility
|
OP
|
$34.11
|
|
| Hospital Charge Code |
901698222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$30.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.15
|
| Rate for Payer: Blue Distinction Transplant |
$20.47
|
| Rate for Payer: Blue Shield of California Commercial |
$21.46
|
| Rate for Payer: Blue Shield of California EPN |
$16.68
|
| Rate for Payer: Cash Price |
$15.35
|
| Rate for Payer: Central Health Plan Commercial |
$27.29
|
| Rate for Payer: Cigna of CA HMO |
$21.83
|
| Rate for Payer: Cigna of CA PPO |
$25.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.99
|
| Rate for Payer: Dignity Health Media |
$28.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.64
|
| Rate for Payer: Galaxy Health WC |
$28.99
|
| Rate for Payer: Global Benefits Group Commercial |
$20.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.82
|
| Rate for Payer: Multiplan Commercial |
$25.58
|
| Rate for Payer: Networks By Design Commercial |
$22.17
|
| Rate for Payer: Prime Health Services Commercial |
$28.99
|
| Rate for Payer: Riverside University Health System MISP |
$13.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.06
|
| Rate for Payer: United Healthcare All Other HMO |
$17.06
|
| Rate for Payer: United Healthcare HMO Rider |
$17.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.99
|
| Rate for Payer: Vantage Medical Group Senior |
$28.99
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PORT
|
Facility
|
IP
|
$34.11
|
|
| Hospital Charge Code |
901698222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$30.70 |
| Rate for Payer: Cash Price |
$15.35
|
| Rate for Payer: Central Health Plan Commercial |
$27.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.64
|
| Rate for Payer: Galaxy Health WC |
$28.99
|
| Rate for Payer: Global Benefits Group Commercial |
$20.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.82
|
| Rate for Payer: Multiplan Commercial |
$25.58
|
| Rate for Payer: Networks By Design Commercial |
$22.17
|
| Rate for Payer: Prime Health Services Commercial |
$28.99
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PRT
|
Facility
|
IP
|
$38.29
|
|
| Hospital Charge Code |
901606359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$34.46 |
| Rate for Payer: Cash Price |
$17.23
|
| Rate for Payer: Central Health Plan Commercial |
$30.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.32
|
| Rate for Payer: Galaxy Health WC |
$32.55
|
| Rate for Payer: Global Benefits Group Commercial |
$22.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.66
|
| Rate for Payer: Multiplan Commercial |
$28.72
|
| Rate for Payer: Networks By Design Commercial |
$24.89
|
| Rate for Payer: Prime Health Services Commercial |
$32.55
|
|
|
HC TUBE FEEDING 12FR 36" DUAL PRT
|
Facility
|
OP
|
$38.29
|
|
| Hospital Charge Code |
901606359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$34.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.62
|
| Rate for Payer: Blue Distinction Transplant |
$22.97
|
| Rate for Payer: Blue Shield of California Commercial |
$24.08
|
| Rate for Payer: Blue Shield of California EPN |
$18.72
|
| Rate for Payer: Cash Price |
$17.23
|
| Rate for Payer: Central Health Plan Commercial |
$30.63
|
| Rate for Payer: Cigna of CA HMO |
$24.51
|
| Rate for Payer: Cigna of CA PPO |
$28.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.55
|
| Rate for Payer: Dignity Health Media |
$32.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.32
|
| Rate for Payer: Galaxy Health WC |
$32.55
|
| Rate for Payer: Global Benefits Group Commercial |
$22.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.66
|
| Rate for Payer: Multiplan Commercial |
$28.72
|
| Rate for Payer: Networks By Design Commercial |
$24.89
|
| Rate for Payer: Prime Health Services Commercial |
$32.55
|
| Rate for Payer: Riverside University Health System MISP |
$15.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.14
|
| Rate for Payer: United Healthcare All Other HMO |
$19.14
|
| Rate for Payer: United Healthcare HMO Rider |
$19.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32.55
|
|
|
HC TUBE FEEDING 12FR, 43CM ENF
|
Facility
|
IP
|
$829.66
|
|
| Hospital Charge Code |
901698437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$746.69 |
| Rate for Payer: Cash Price |
$373.35
|
| Rate for Payer: Central Health Plan Commercial |
$663.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.86
|
| Rate for Payer: Galaxy Health WC |
$705.21
|
| Rate for Payer: Global Benefits Group Commercial |
$497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.93
|
| Rate for Payer: Multiplan Commercial |
$622.24
|
| Rate for Payer: Networks By Design Commercial |
$539.28
|
| Rate for Payer: Prime Health Services Commercial |
$705.21
|
|
|
HC TUBE FEEDING 12FR, 43CM ENF
|
Facility
|
OP
|
$829.66
|
|
| Hospital Charge Code |
901698437
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.93 |
| Max. Negotiated Rate |
$746.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$503.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$705.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$456.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$401.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$490.16
|
| Rate for Payer: Blue Distinction Transplant |
$497.80
|
| Rate for Payer: Blue Shield of California Commercial |
$521.86
|
| Rate for Payer: Blue Shield of California EPN |
$405.70
|
| Rate for Payer: Cash Price |
$373.35
|
| Rate for Payer: Central Health Plan Commercial |
$663.73
|
| Rate for Payer: Cigna of CA HMO |
$530.98
|
| Rate for Payer: Cigna of CA PPO |
$613.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$705.21
|
| Rate for Payer: Dignity Health Media |
$705.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$705.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$331.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$331.86
|
| Rate for Payer: Galaxy Health WC |
$705.21
|
| Rate for Payer: Global Benefits Group Commercial |
$497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$746.69
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$622.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.93
|
| Rate for Payer: Multiplan Commercial |
$622.24
|
| Rate for Payer: Networks By Design Commercial |
$539.28
|
| Rate for Payer: Prime Health Services Commercial |
$705.21
|
| Rate for Payer: Riverside University Health System MISP |
$331.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$497.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$497.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$414.83
|
| Rate for Payer: United Healthcare All Other HMO |
$414.83
|
| Rate for Payer: United Healthcare HMO Rider |
$414.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$414.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$705.21
|
| Rate for Payer: Vantage Medical Group Senior |
$705.21
|
|
|
HC TUBE FEEDING 5FR 22" W/STYLET
|
Facility
|
IP
|
$111.11
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.22 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Central Health Plan Commercial |
$88.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.44
|
| Rate for Payer: Galaxy Health WC |
$94.44
|
| Rate for Payer: Global Benefits Group Commercial |
$66.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.22
|
| Rate for Payer: Multiplan Commercial |
$83.33
|
| Rate for Payer: Networks By Design Commercial |
$72.22
|
| Rate for Payer: Prime Health Services Commercial |
$94.44
|
|
|
HC TUBE FEEDING 5FR 22" W/STYLET
|
Facility
|
OP
|
$111.11
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.22 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.64
|
| Rate for Payer: Blue Distinction Transplant |
$66.67
|
| Rate for Payer: Blue Shield of California Commercial |
$69.89
|
| Rate for Payer: Blue Shield of California EPN |
$54.33
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Central Health Plan Commercial |
$88.89
|
| Rate for Payer: Cigna of CA HMO |
$71.11
|
| Rate for Payer: Cigna of CA PPO |
$82.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.44
|
| Rate for Payer: Dignity Health Media |
$94.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$44.44
|
| Rate for Payer: Galaxy Health WC |
$94.44
|
| Rate for Payer: Global Benefits Group Commercial |
$66.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$83.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.22
|
| Rate for Payer: Multiplan Commercial |
$83.33
|
| Rate for Payer: Networks By Design Commercial |
$72.22
|
| Rate for Payer: Prime Health Services Commercial |
$94.44
|
| Rate for Payer: Riverside University Health System MISP |
$44.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.56
|
| Rate for Payer: United Healthcare All Other HMO |
$55.56
|
| Rate for Payer: United Healthcare HMO Rider |
$55.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.44
|
| Rate for Payer: Vantage Medical Group Senior |
$94.44
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
OP
|
$124.87
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$112.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.77
|
| Rate for Payer: Blue Distinction Transplant |
$74.92
|
| Rate for Payer: Blue Shield of California Commercial |
$78.54
|
| Rate for Payer: Blue Shield of California EPN |
$61.06
|
| Rate for Payer: Cash Price |
$56.19
|
| Rate for Payer: Cash Price |
$56.19
|
| Rate for Payer: Central Health Plan Commercial |
$99.90
|
| Rate for Payer: Cigna of CA HMO |
$79.92
|
| Rate for Payer: Cigna of CA PPO |
$92.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.14
|
| Rate for Payer: Dignity Health Media |
$106.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$49.95
|
| Rate for Payer: Galaxy Health WC |
$106.14
|
| Rate for Payer: Global Benefits Group Commercial |
$74.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$93.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$43.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.97
|
| Rate for Payer: Multiplan Commercial |
$93.65
|
| Rate for Payer: Networks By Design Commercial |
$81.17
|
| Rate for Payer: Prime Health Services Commercial |
$106.14
|
| Rate for Payer: Riverside University Health System MISP |
$49.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.44
|
| Rate for Payer: United Healthcare All Other HMO |
$62.44
|
| Rate for Payer: United Healthcare HMO Rider |
$62.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.14
|
| Rate for Payer: Vantage Medical Group Senior |
$106.14
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
IP
|
$124.87
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$112.38 |
| Rate for Payer: Cash Price |
$56.19
|
| Rate for Payer: Central Health Plan Commercial |
$99.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.95
|
| Rate for Payer: Galaxy Health WC |
$106.14
|
| Rate for Payer: Global Benefits Group Commercial |
$74.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.97
|
| Rate for Payer: Multiplan Commercial |
$93.65
|
| Rate for Payer: Networks By Design Commercial |
$81.17
|
| Rate for Payer: Prime Health Services Commercial |
$106.14
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
IP
|
$98.27
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$88.44 |
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Central Health Plan Commercial |
$78.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.31
|
| Rate for Payer: Galaxy Health WC |
$83.53
|
| Rate for Payer: Global Benefits Group Commercial |
$58.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.65
|
| Rate for Payer: Multiplan Commercial |
$73.70
|
| Rate for Payer: Networks By Design Commercial |
$63.88
|
| Rate for Payer: Prime Health Services Commercial |
$83.53
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
OP
|
$98.27
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$88.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.06
|
| Rate for Payer: Blue Distinction Transplant |
$58.96
|
| Rate for Payer: Blue Shield of California Commercial |
$61.81
|
| Rate for Payer: Blue Shield of California EPN |
$48.05
|
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Central Health Plan Commercial |
$78.62
|
| Rate for Payer: Cigna of CA HMO |
$62.89
|
| Rate for Payer: Cigna of CA PPO |
$72.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.53
|
| Rate for Payer: Dignity Health Media |
$83.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.31
|
| Rate for Payer: Galaxy Health WC |
$83.53
|
| Rate for Payer: Global Benefits Group Commercial |
$58.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.44
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$73.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.65
|
| Rate for Payer: Multiplan Commercial |
$73.70
|
| Rate for Payer: Networks By Design Commercial |
$63.88
|
| Rate for Payer: Prime Health Services Commercial |
$83.53
|
| Rate for Payer: Riverside University Health System MISP |
$39.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.14
|
| Rate for Payer: United Healthcare All Other HMO |
$49.14
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.53
|
| Rate for Payer: Vantage Medical Group Senior |
$83.53
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
IP
|
$98.27
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$88.44 |
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Central Health Plan Commercial |
$78.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.31
|
| Rate for Payer: Galaxy Health WC |
$83.53
|
| Rate for Payer: Global Benefits Group Commercial |
$58.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.65
|
| Rate for Payer: Multiplan Commercial |
$73.70
|
| Rate for Payer: Networks By Design Commercial |
$63.88
|
| Rate for Payer: Prime Health Services Commercial |
$83.53
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
OP
|
$98.27
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$88.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.06
|
| Rate for Payer: Blue Distinction Transplant |
$58.96
|
| Rate for Payer: Blue Shield of California Commercial |
$61.81
|
| Rate for Payer: Blue Shield of California EPN |
$48.05
|
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Cash Price |
$44.22
|
| Rate for Payer: Central Health Plan Commercial |
$78.62
|
| Rate for Payer: Cigna of CA HMO |
$62.89
|
| Rate for Payer: Cigna of CA PPO |
$72.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.53
|
| Rate for Payer: Dignity Health Media |
$83.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.31
|
| Rate for Payer: Galaxy Health WC |
$83.53
|
| Rate for Payer: Global Benefits Group Commercial |
$58.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.44
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$73.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.65
|
| Rate for Payer: Multiplan Commercial |
$73.70
|
| Rate for Payer: Networks By Design Commercial |
$63.88
|
| Rate for Payer: Prime Health Services Commercial |
$83.53
|
| Rate for Payer: Riverside University Health System MISP |
$39.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.14
|
| Rate for Payer: United Healthcare All Other HMO |
$49.14
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.53
|
| Rate for Payer: Vantage Medical Group Senior |
$83.53
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
IP
|
$75.77
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$68.19 |
| Rate for Payer: Cash Price |
$34.10
|
| Rate for Payer: Central Health Plan Commercial |
$60.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.31
|
| Rate for Payer: Galaxy Health WC |
$64.40
|
| Rate for Payer: Global Benefits Group Commercial |
$45.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.15
|
| Rate for Payer: Multiplan Commercial |
$56.83
|
| Rate for Payer: Networks By Design Commercial |
$49.25
|
| Rate for Payer: Prime Health Services Commercial |
$64.40
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
OP
|
$75.77
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$68.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.76
|
| Rate for Payer: Blue Distinction Transplant |
$45.46
|
| Rate for Payer: Blue Shield of California Commercial |
$47.66
|
| Rate for Payer: Blue Shield of California EPN |
$37.05
|
| Rate for Payer: Cash Price |
$34.10
|
| Rate for Payer: Central Health Plan Commercial |
$60.62
|
| Rate for Payer: Cigna of CA HMO |
$48.49
|
| Rate for Payer: Cigna of CA PPO |
$56.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.40
|
| Rate for Payer: Dignity Health Media |
$64.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.31
|
| Rate for Payer: Galaxy Health WC |
$64.40
|
| Rate for Payer: Global Benefits Group Commercial |
$45.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.19
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$56.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.15
|
| Rate for Payer: Multiplan Commercial |
$56.83
|
| Rate for Payer: Networks By Design Commercial |
$49.25
|
| Rate for Payer: Prime Health Services Commercial |
$64.40
|
| Rate for Payer: Riverside University Health System MISP |
$30.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$37.88
|
| Rate for Payer: United Healthcare All Other HMO |
$37.88
|
| Rate for Payer: United Healthcare HMO Rider |
$37.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.40
|
| Rate for Payer: Vantage Medical Group Senior |
$64.40
|
|
|
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: 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 |
$6.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.46
|
| Rate for Payer: Blue Distinction Transplant |
$7.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7.94
|
| Rate for Payer: Blue Shield of California EPN |
$6.18
|
| 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 Media |
$10.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$9.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.81
|
| 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
|
| 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 Medi-Cal |
$10.74
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
