|
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
|
|
|
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: 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 |
$79.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.36
|
| Rate for Payer: Blue Distinction Transplant |
$86.69
|
| Rate for Payer: Blue Shield of California Commercial |
$90.88
|
| Rate for Payer: Blue Shield of California EPN |
$70.65
|
| 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 Media |
$122.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$122.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$108.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$50.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.90
|
| 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 Medi-Cal |
$122.81
|
| Rate for Payer: Vantage Medical Group Senior |
$122.81
|
|
|
HC TUBE FEEDING ARGYLE 8FR, 16"
|
Facility
|
IP
|
$144.48
|
|
| Hospital Charge Code |
901607669
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.90 |
| Max. Negotiated Rate |
$130.03 |
| Rate for Payer: Cash Price |
$65.02
|
| Rate for Payer: Central Health Plan Commercial |
$115.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$96.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.90
|
| 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
|
|
|
HC TUBE FEEDING CONTINUOUS GT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901602534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC TUBE FEEDING CONTINUOUS GT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901602534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC TUBE FEEDING CORFLO 5FR 22"
|
Facility
|
OP
|
$99.48
|
|
| Hospital Charge Code |
901605399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$89.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.77
|
| Rate for Payer: Blue Distinction Transplant |
$59.69
|
| Rate for Payer: Blue Shield of California Commercial |
$62.57
|
| Rate for Payer: Blue Shield of California EPN |
$48.65
|
| Rate for Payer: Cash Price |
$44.77
|
| Rate for Payer: Central Health Plan Commercial |
$79.58
|
| Rate for Payer: Cigna of CA HMO |
$63.67
|
| Rate for Payer: Cigna of CA PPO |
$73.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.56
|
| Rate for Payer: Dignity Health Media |
$84.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.79
|
| Rate for Payer: Galaxy Health WC |
$84.56
|
| Rate for Payer: Global Benefits Group Commercial |
$59.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.53
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$74.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.90
|
| Rate for Payer: Multiplan Commercial |
$74.61
|
| Rate for Payer: Networks By Design Commercial |
$64.66
|
| Rate for Payer: Prime Health Services Commercial |
$84.56
|
| Rate for Payer: Riverside University Health System MISP |
$39.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.74
|
| Rate for Payer: United Healthcare All Other HMO |
$49.74
|
| Rate for Payer: United Healthcare HMO Rider |
$49.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.56
|
| Rate for Payer: Vantage Medical Group Senior |
$84.56
|
|
|
HC TUBE FEEDING CORFLO 5FR 22"
|
Facility
|
IP
|
$99.48
|
|
| Hospital Charge Code |
901605399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$89.53 |
| Rate for Payer: Cash Price |
$44.77
|
| Rate for Payer: Central Health Plan Commercial |
$79.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.79
|
| Rate for Payer: Galaxy Health WC |
$84.56
|
| Rate for Payer: Global Benefits Group Commercial |
$59.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.90
|
| Rate for Payer: Multiplan Commercial |
$74.61
|
| Rate for Payer: Networks By Design Commercial |
$64.66
|
| Rate for Payer: Prime Health Services Commercial |
$84.56
|
|
|
HC TUBE FEEDING CORFLO FR 36"
|
Facility
|
OP
|
$106.32
|
|
| Hospital Charge Code |
901605400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.26 |
| Max. Negotiated Rate |
$95.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.81
|
| Rate for Payer: Blue Distinction Transplant |
$63.79
|
| Rate for Payer: Blue Shield of California Commercial |
$66.88
|
| Rate for Payer: Blue Shield of California EPN |
$51.99
|
| Rate for Payer: Cash Price |
$47.84
|
| Rate for Payer: Central Health Plan Commercial |
$85.06
|
| Rate for Payer: Cigna of CA HMO |
$68.04
|
| Rate for Payer: Cigna of CA PPO |
$78.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.37
|
| Rate for Payer: Dignity Health Media |
$90.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.53
|
| Rate for Payer: Galaxy Health WC |
$90.37
|
| Rate for Payer: Global Benefits Group Commercial |
$63.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.69
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$79.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.26
|
| Rate for Payer: Multiplan Commercial |
$79.74
|
| Rate for Payer: Networks By Design Commercial |
$69.11
|
| Rate for Payer: Prime Health Services Commercial |
$90.37
|
| Rate for Payer: Riverside University Health System MISP |
$42.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.16
|
| Rate for Payer: United Healthcare All Other HMO |
$53.16
|
| Rate for Payer: United Healthcare HMO Rider |
$53.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.37
|
| Rate for Payer: Vantage Medical Group Senior |
$90.37
|
|
|
HC TUBE FEEDING CORFLO FR 36"
|
Facility
|
IP
|
$106.32
|
|
| Hospital Charge Code |
901605400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.26 |
| Max. Negotiated Rate |
$95.69 |
| Rate for Payer: Cash Price |
$47.84
|
| Rate for Payer: Central Health Plan Commercial |
$85.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.53
|
| Rate for Payer: Galaxy Health WC |
$90.37
|
| Rate for Payer: Global Benefits Group Commercial |
$63.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.26
|
| Rate for Payer: Multiplan Commercial |
$79.74
|
| Rate for Payer: Networks By Design Commercial |
$69.11
|
| Rate for Payer: Prime Health Services Commercial |
$90.37
|
|
|
HC TUBE FEEDING ENT 6 1/2FRX16"
|
Facility
|
OP
|
$78.23
|
|
| Hospital Charge Code |
901698725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$70.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.22
|
| Rate for Payer: Blue Distinction Transplant |
$46.94
|
| Rate for Payer: Blue Shield of California Commercial |
$49.21
|
| Rate for Payer: Blue Shield of California EPN |
$38.25
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Central Health Plan Commercial |
$62.58
|
| Rate for Payer: Cigna of CA HMO |
$50.07
|
| Rate for Payer: Cigna of CA PPO |
$57.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66.50
|
| Rate for Payer: Dignity Health Media |
$66.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$66.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$31.29
|
| Rate for Payer: Galaxy Health WC |
$66.50
|
| Rate for Payer: Global Benefits Group Commercial |
$46.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.41
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$58.67
|
| Rate for Payer: Networks By Design Commercial |
$50.85
|
| Rate for Payer: Prime Health Services Commercial |
$66.50
|
| Rate for Payer: Riverside University Health System MISP |
$31.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.12
|
| Rate for Payer: United Healthcare All Other HMO |
$39.12
|
| Rate for Payer: United Healthcare HMO Rider |
$39.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66.50
|
| Rate for Payer: Vantage Medical Group Senior |
$66.50
|
|
|
HC TUBE FEEDING ENT 6 1/2FRX16"
|
Facility
|
IP
|
$78.23
|
|
| Hospital Charge Code |
901698725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$70.41 |
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Central Health Plan Commercial |
$62.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.29
|
| Rate for Payer: Galaxy Health WC |
$66.50
|
| Rate for Payer: Global Benefits Group Commercial |
$46.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.65
|
| Rate for Payer: Multiplan Commercial |
$58.67
|
| Rate for Payer: Networks By Design Commercial |
$50.85
|
| Rate for Payer: Prime Health Services Commercial |
$66.50
|
|
|
HC TUBE FEEDING ENTERAL 10FR 43"
|
Facility
|
OP
|
$95.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.35
|
| Rate for Payer: Blue Distinction Transplant |
$57.23
|
| Rate for Payer: Blue Shield of California Commercial |
$59.99
|
| Rate for Payer: Blue Shield of California EPN |
$46.64
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Media |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Riverside University Health System MISP |
$38.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC TUBE FEEDING ENTERAL 10FR 43"
|
Facility
|
IP
|
$95.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.54
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC TUBE FEEDING ENTERAL 8FR 42"
|
Facility
|
IP
|
$9.10
|
|
| Hospital Charge Code |
901600730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$8.19 |
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Central Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.64
|
| Rate for Payer: Galaxy Health WC |
$7.74
|
| Rate for Payer: Global Benefits Group Commercial |
$5.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: Multiplan Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$5.92
|
| Rate for Payer: Prime Health Services Commercial |
$7.74
|
|
|
HC TUBE FEEDING ENTERAL 8FR 42"
|
Facility
|
OP
|
$9.10
|
|
| Hospital Charge Code |
901600730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$8.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.38
|
| Rate for Payer: Blue Distinction Transplant |
$5.46
|
| Rate for Payer: Blue Shield of California Commercial |
$5.72
|
| Rate for Payer: Blue Shield of California EPN |
$4.45
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Central Health Plan Commercial |
$7.28
|
| Rate for Payer: Cigna of CA HMO |
$5.82
|
| Rate for Payer: Cigna of CA PPO |
$6.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.74
|
| Rate for Payer: Dignity Health Media |
$7.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.64
|
| Rate for Payer: Galaxy Health WC |
$7.74
|
| Rate for Payer: Global Benefits Group Commercial |
$5.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.19
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: Multiplan Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$5.92
|
| Rate for Payer: Prime Health Services Commercial |
$7.74
|
| Rate for Payer: Riverside University Health System MISP |
$3.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.55
|
| Rate for Payer: United Healthcare All Other HMO |
$4.55
|
| Rate for Payer: United Healthcare HMO Rider |
$4.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.74
|
| Rate for Payer: Vantage Medical Group Senior |
$7.74
|
|
|
HC TUBE FEEDING ENTRIFLEX 12FR
|
Facility
|
OP
|
$107.84
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.57 |
| Max. Negotiated Rate |
$97.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.71
|
| Rate for Payer: Blue Distinction Transplant |
$64.70
|
| Rate for Payer: Blue Shield of California Commercial |
$67.83
|
| Rate for Payer: Blue Shield of California EPN |
$52.73
|
| Rate for Payer: Cash Price |
$48.53
|
| Rate for Payer: Cash Price |
$48.53
|
| Rate for Payer: Central Health Plan Commercial |
$86.27
|
| Rate for Payer: Cigna of CA HMO |
$69.02
|
| Rate for Payer: Cigna of CA PPO |
$79.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.66
|
| Rate for Payer: Dignity Health Media |
$91.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.14
|
| Rate for Payer: Galaxy Health WC |
$91.66
|
| Rate for Payer: Global Benefits Group Commercial |
$64.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.06
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$80.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$71.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.57
|
| Rate for Payer: Multiplan Commercial |
$80.88
|
| Rate for Payer: Networks By Design Commercial |
$70.10
|
| Rate for Payer: Prime Health Services Commercial |
$91.66
|
| Rate for Payer: Riverside University Health System MISP |
$43.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.92
|
| Rate for Payer: United Healthcare All Other HMO |
$53.92
|
| Rate for Payer: United Healthcare HMO Rider |
$53.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.66
|
| Rate for Payer: Vantage Medical Group Senior |
$91.66
|
|
|
HC TUBE FEEDING ENTRIFLEX 12FR
|
Facility
|
IP
|
$107.84
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.57 |
| Max. Negotiated Rate |
$97.06 |
| Rate for Payer: Cash Price |
$48.53
|
| Rate for Payer: Central Health Plan Commercial |
$86.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.14
|
| Rate for Payer: Galaxy Health WC |
$91.66
|
| Rate for Payer: Global Benefits Group Commercial |
$64.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$71.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.57
|
| Rate for Payer: Multiplan Commercial |
$80.88
|
| Rate for Payer: Networks By Design Commercial |
$70.10
|
| Rate for Payer: Prime Health Services Commercial |
$91.66
|
|
|
HC TUBE FEEDING NG W/STYLET 12FR
|
Facility
|
OP
|
$138.17
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.63 |
| Max. Negotiated Rate |
$124.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.63
|
| Rate for Payer: Blue Distinction Transplant |
$82.90
|
| Rate for Payer: Blue Shield of California Commercial |
$86.91
|
| Rate for Payer: Blue Shield of California EPN |
$67.57
|
| Rate for Payer: Cash Price |
$62.18
|
| Rate for Payer: Cash Price |
$62.18
|
| Rate for Payer: Central Health Plan Commercial |
$110.54
|
| Rate for Payer: Cigna of CA HMO |
$88.43
|
| Rate for Payer: Cigna of CA PPO |
$102.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.44
|
| Rate for Payer: Dignity Health Media |
$117.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$55.27
|
| Rate for Payer: Galaxy Health WC |
$117.44
|
| Rate for Payer: Global Benefits Group Commercial |
$82.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.35
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$103.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.63
|
| Rate for Payer: Multiplan Commercial |
$103.63
|
| Rate for Payer: Networks By Design Commercial |
$89.81
|
| Rate for Payer: Prime Health Services Commercial |
$117.44
|
| Rate for Payer: Riverside University Health System MISP |
$55.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.08
|
| Rate for Payer: United Healthcare All Other HMO |
$69.08
|
| Rate for Payer: United Healthcare HMO Rider |
$69.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.44
|
| Rate for Payer: Vantage Medical Group Senior |
$117.44
|
|
|
HC TUBE FEEDING NG W/STYLET 12FR
|
Facility
|
IP
|
$138.17
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698721
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.63 |
| Max. Negotiated Rate |
$124.35 |
| Rate for Payer: Cash Price |
$62.18
|
| Rate for Payer: Central Health Plan Commercial |
$110.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.27
|
| Rate for Payer: Galaxy Health WC |
$117.44
|
| Rate for Payer: Global Benefits Group Commercial |
$82.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.63
|
| Rate for Payer: Multiplan Commercial |
$103.63
|
| Rate for Payer: Networks By Design Commercial |
$89.81
|
| Rate for Payer: Prime Health Services Commercial |
$117.44
|
|
|
HC TUBE FEEDING PVC 5FR 16"
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
901606117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.95
|
| Rate for Payer: Blue Distinction Transplant |
$3.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3.14
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: Cigna of CA HMO |
$3.20
|
| Rate for Payer: Cigna of CA PPO |
$3.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.25
|
| Rate for Payer: Dignity Health Media |
$4.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4.25
|
|
|
HC TUBE FEEDING PVC 5FR 16"
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
901606117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Central Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$3.75
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
HC TUBE FEEDING PVC 5FR PURPLE
|
Facility
|
IP
|
$32.64
|
|
| Hospital Charge Code |
901698715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
|
|
HC TUBE FEEDING PVC 5FR PURPLE
|
Facility
|
OP
|
$32.64
|
|
| Hospital Charge Code |
901698715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.28
|
| Rate for Payer: Blue Distinction Transplant |
$19.58
|
| Rate for Payer: Blue Shield of California Commercial |
$20.53
|
| Rate for Payer: Blue Shield of California EPN |
$15.96
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: Cigna of CA HMO |
$20.89
|
| Rate for Payer: Cigna of CA PPO |
$24.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.74
|
| Rate for Payer: Dignity Health Media |
$27.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
| Rate for Payer: Riverside University Health System MISP |
$13.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.32
|
| Rate for Payer: United Healthcare All Other HMO |
$16.32
|
| Rate for Payer: United Healthcare HMO Rider |
$16.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.74
|
| Rate for Payer: Vantage Medical Group Senior |
$27.74
|
|
|
HC TUBE FEEDING PVC 5FR SHORT
|
Facility
|
IP
|
$32.64
|
|
| Hospital Charge Code |
901698714
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
|
|
HC TUBE FEEDING PVC 5FR SHORT
|
Facility
|
OP
|
$32.64
|
|
| Hospital Charge Code |
901698714
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.28
|
| Rate for Payer: Blue Distinction Transplant |
$19.58
|
| Rate for Payer: Blue Shield of California Commercial |
$20.53
|
| Rate for Payer: Blue Shield of California EPN |
$15.96
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Central Health Plan Commercial |
$26.11
|
| Rate for Payer: Cigna of CA HMO |
$20.89
|
| Rate for Payer: Cigna of CA PPO |
$24.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.74
|
| Rate for Payer: Dignity Health Media |
$27.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$24.48
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
| Rate for Payer: Riverside University Health System MISP |
$13.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.32
|
| Rate for Payer: United Healthcare All Other HMO |
$16.32
|
| Rate for Payer: United Healthcare HMO Rider |
$16.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.74
|
| Rate for Payer: Vantage Medical Group Senior |
$27.74
|
|
