|
HC TUBE GASTROSTOMY 18FR
|
Facility
IP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
|
|
HC TUBE GASTROSTOMY 18FR
|
Facility
OP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$193.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.66
|
| Rate for Payer: BCBS Transplant Transplant |
$136.75
|
| Rate for Payer: Blue Shield of California Commercial |
$143.36
|
| Rate for Payer: Blue Shield of California EPN |
$111.45
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: Cigna of CA HMO |
$145.87
|
| Rate for Payer: Cigna of CA PPO |
$168.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$170.94
|
| Rate for Payer: IEHP medi-cal |
$79.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: Riverside University Health MISP |
$91.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.96
|
| Rate for Payer: United Healthcare All Other HMO |
$113.96
|
| Rate for Payer: United Healthcare HMO Rider |
$113.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.73
|
| Rate for Payer: Vantage Medical Group Senior |
$193.73
|
|
|
HC TUBE GASTROSTOMY 18FR 3-PORT
|
Facility
IP
|
$242.62
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698682
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$218.36 |
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Central Health Plan Commercial |
$194.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.05
|
| Rate for Payer: Galaxy Health WC |
$206.23
|
| Rate for Payer: Global Benefits Group Commercial |
$145.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.52
|
| Rate for Payer: Multiplan Commercial |
$181.96
|
| Rate for Payer: Networks By Design Commercial |
$157.70
|
| Rate for Payer: Prime Health Services Commercial |
$206.23
|
|
|
HC TUBE GASTROSTOMY 18FR 3-PORT
|
Facility
OP
|
$242.62
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698682
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$218.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$133.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$133.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.34
|
| Rate for Payer: BCBS Transplant Transplant |
$145.57
|
| Rate for Payer: Blue Shield of California Commercial |
$152.61
|
| Rate for Payer: Blue Shield of California EPN |
$118.64
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Cash Price |
$109.18
|
| Rate for Payer: Central Health Plan Commercial |
$194.10
|
| Rate for Payer: Cigna of CA HMO |
$155.28
|
| Rate for Payer: Cigna of CA PPO |
$179.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.05
|
| Rate for Payer: Galaxy Health WC |
$206.23
|
| Rate for Payer: Global Benefits Group Commercial |
$145.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.36
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$181.96
|
| Rate for Payer: IEHP medi-cal |
$84.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.52
|
| Rate for Payer: Multiplan Commercial |
$181.96
|
| Rate for Payer: Networks By Design Commercial |
$157.70
|
| Rate for Payer: Prime Health Services Commercial |
$206.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$145.57
|
| Rate for Payer: Riverside University Health MISP |
$97.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.31
|
| Rate for Payer: United Healthcare All Other HMO |
$121.31
|
| Rate for Payer: United Healthcare HMO Rider |
$121.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.23
|
| Rate for Payer: Vantage Medical Group Senior |
$206.23
|
|
|
HC TUBE GASTROSTOMY 20FR
|
Facility
OP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698764
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$193.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.66
|
| Rate for Payer: BCBS Transplant Transplant |
$136.75
|
| Rate for Payer: Blue Shield of California Commercial |
$143.36
|
| Rate for Payer: Blue Shield of California EPN |
$111.45
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: Cigna of CA HMO |
$145.87
|
| Rate for Payer: Cigna of CA PPO |
$168.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$170.94
|
| Rate for Payer: IEHP medi-cal |
$79.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: Riverside University Health MISP |
$91.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.96
|
| Rate for Payer: United Healthcare All Other HMO |
$113.96
|
| Rate for Payer: United Healthcare HMO Rider |
$113.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.73
|
| Rate for Payer: Vantage Medical Group Senior |
$193.73
|
|
|
HC TUBE GASTROSTOMY 20FR
|
Facility
IP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698764
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
|
|
HC TUBE GASTROSTOMY 20FR 2CM LP
|
Facility
IP
|
$575.82
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901604390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.16 |
| Max. Negotiated Rate |
$518.24 |
| Rate for Payer: Cash Price |
$259.12
|
| Rate for Payer: Central Health Plan Commercial |
$460.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.33
|
| Rate for Payer: Galaxy Health WC |
$489.45
|
| Rate for Payer: Global Benefits Group Commercial |
$345.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.16
|
| Rate for Payer: Multiplan Commercial |
$431.86
|
| Rate for Payer: Networks By Design Commercial |
$374.28
|
| Rate for Payer: Prime Health Services Commercial |
$489.45
|
|
|
HC TUBE GASTROSTOMY 20FR 2CM LP
|
Facility
OP
|
$575.82
|
|
|
Service Code
|
CPT B4088
|
| Hospital Charge Code |
901604390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.79 |
| Max. Negotiated Rate |
$518.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$489.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$316.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$316.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$278.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.19
|
| Rate for Payer: BCBS Transplant Transplant |
$345.49
|
| Rate for Payer: Blue Shield of California Commercial |
$362.19
|
| Rate for Payer: Blue Shield of California EPN |
$281.58
|
| Rate for Payer: Cash Price |
$259.12
|
| Rate for Payer: Cash Price |
$259.12
|
| Rate for Payer: Central Health Plan Commercial |
$460.66
|
| Rate for Payer: Cigna of CA HMO |
$368.52
|
| Rate for Payer: Cigna of CA PPO |
$426.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$489.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$230.33
|
| Rate for Payer: Galaxy Health WC |
$489.45
|
| Rate for Payer: Global Benefits Group Commercial |
$345.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$518.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$431.86
|
| Rate for Payer: IEHP medi-cal |
$201.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.16
|
| Rate for Payer: Multiplan Commercial |
$431.86
|
| Rate for Payer: Networks By Design Commercial |
$374.28
|
| Rate for Payer: Prime Health Services Commercial |
$489.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$345.49
|
| Rate for Payer: Riverside University Health MISP |
$230.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$345.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$345.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$287.91
|
| Rate for Payer: United Healthcare All Other HMO |
$287.91
|
| Rate for Payer: United Healthcare HMO Rider |
$287.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$489.45
|
| Rate for Payer: Vantage Medical Group Senior |
$489.45
|
|
|
HC TUBE GASTROSTOMY 22FR
|
Facility
OP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$193.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.66
|
| Rate for Payer: BCBS Transplant Transplant |
$136.75
|
| Rate for Payer: Blue Shield of California Commercial |
$143.36
|
| Rate for Payer: Blue Shield of California EPN |
$111.45
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: Cigna of CA HMO |
$145.87
|
| Rate for Payer: Cigna of CA PPO |
$168.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$170.94
|
| Rate for Payer: IEHP medi-cal |
$79.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: Riverside University Health MISP |
$91.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.96
|
| Rate for Payer: United Healthcare All Other HMO |
$113.96
|
| Rate for Payer: United Healthcare HMO Rider |
$113.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.73
|
| Rate for Payer: Vantage Medical Group Senior |
$193.73
|
|
|
HC TUBE GASTROSTOMY 22FR
|
Facility
IP
|
$227.92
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901602320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$205.13 |
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Central Health Plan Commercial |
$182.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.17
|
| Rate for Payer: Galaxy Health WC |
$193.73
|
| Rate for Payer: Global Benefits Group Commercial |
$136.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$170.94
|
| Rate for Payer: Networks By Design Commercial |
$148.15
|
| Rate for Payer: Prime Health Services Commercial |
$193.73
|
|
|
HC TUBE GASTROSTOMY 22FR 7-10ML
|
Facility
IP
|
$223.51
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698406
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$44.70 |
| Max. Negotiated Rate |
$201.16 |
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Central Health Plan Commercial |
$178.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.40
|
| Rate for Payer: Galaxy Health WC |
$189.98
|
| Rate for Payer: Global Benefits Group Commercial |
$134.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$149.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.70
|
| Rate for Payer: Multiplan Commercial |
$167.63
|
| Rate for Payer: Networks By Design Commercial |
$145.28
|
| Rate for Payer: Prime Health Services Commercial |
$189.98
|
|
|
HC TUBE GASTROSTOMY 22FR 7-10ML
|
Facility
OP
|
$223.51
|
|
|
Service Code
|
CPT B4087
|
| Hospital Charge Code |
901698406
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$44.70 |
| Max. Negotiated Rate |
$201.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$189.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$122.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.05
|
| Rate for Payer: BCBS Transplant Transplant |
$134.11
|
| Rate for Payer: Blue Shield of California Commercial |
$140.59
|
| Rate for Payer: Blue Shield of California EPN |
$109.30
|
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Cash Price |
$100.58
|
| Rate for Payer: Central Health Plan Commercial |
$178.81
|
| Rate for Payer: Cigna of CA HMO |
$143.05
|
| Rate for Payer: Cigna of CA PPO |
$165.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$189.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$89.40
|
| Rate for Payer: Galaxy Health WC |
$189.98
|
| Rate for Payer: Global Benefits Group Commercial |
$134.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.16
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$167.63
|
| Rate for Payer: IEHP medi-cal |
$78.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$149.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.70
|
| Rate for Payer: Multiplan Commercial |
$167.63
|
| Rate for Payer: Networks By Design Commercial |
$145.28
|
| Rate for Payer: Prime Health Services Commercial |
$189.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$134.11
|
| Rate for Payer: Riverside University Health MISP |
$89.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$134.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$134.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.76
|
| Rate for Payer: United Healthcare All Other HMO |
$111.76
|
| Rate for Payer: United Healthcare HMO Rider |
$111.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$111.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$189.98
|
| Rate for Payer: Vantage Medical Group Senior |
$189.98
|
|
|
HC TUBE JEJUNOSTOMY 18FRX4.0CM LOW PROF
|
Facility
OP
|
$769.03
|
|
| Hospital Charge Code |
900100543
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$153.81 |
| Max. Negotiated Rate |
$692.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$467.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$653.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$422.97
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$422.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$372.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$454.34
|
| Rate for Payer: BCBS Transplant Transplant |
$461.42
|
| Rate for Payer: Blue Shield of California Commercial |
$483.72
|
| Rate for Payer: Blue Shield of California EPN |
$376.06
|
| Rate for Payer: Cash Price |
$346.06
|
| Rate for Payer: Central Health Plan Commercial |
$615.22
|
| Rate for Payer: Cigna of CA HMO |
$492.18
|
| Rate for Payer: Cigna of CA PPO |
$569.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$653.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$307.61
|
| Rate for Payer: Galaxy Health WC |
$653.68
|
| Rate for Payer: Global Benefits Group Commercial |
$461.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$692.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$576.77
|
| Rate for Payer: IEHP medi-cal |
$269.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$512.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.81
|
| Rate for Payer: Multiplan Commercial |
$576.77
|
| Rate for Payer: Networks By Design Commercial |
$499.87
|
| Rate for Payer: Prime Health Services Commercial |
$653.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$461.42
|
| Rate for Payer: Riverside University Health MISP |
$307.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$461.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$461.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$384.52
|
| Rate for Payer: United Healthcare All Other HMO |
$384.52
|
| Rate for Payer: United Healthcare HMO Rider |
$384.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$384.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$653.68
|
| Rate for Payer: Vantage Medical Group Senior |
$653.68
|
|
|
HC TUBE JEJUNOSTOMY 18FRX4.0CM LOW PROF
|
Facility
IP
|
$769.03
|
|
| Hospital Charge Code |
900100543
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$153.81 |
| Max. Negotiated Rate |
$692.13 |
| Rate for Payer: Cash Price |
$346.06
|
| Rate for Payer: Central Health Plan Commercial |
$615.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.61
|
| Rate for Payer: Galaxy Health WC |
$653.68
|
| Rate for Payer: Global Benefits Group Commercial |
$461.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$692.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$512.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.81
|
| Rate for Payer: Multiplan Commercial |
$576.77
|
| Rate for Payer: Networks By Design Commercial |
$499.87
|
| Rate for Payer: Prime Health Services Commercial |
$653.68
|
|
|
HC TUBE NASOGASTRIC 10FR W/STYLET
|
Facility
IP
|
$114.91
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.98 |
| Max. Negotiated Rate |
$103.42 |
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Central Health Plan Commercial |
$91.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.96
|
| Rate for Payer: Galaxy Health WC |
$97.67
|
| Rate for Payer: Global Benefits Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.98
|
| Rate for Payer: Multiplan Commercial |
$86.18
|
| Rate for Payer: Networks By Design Commercial |
$74.69
|
| Rate for Payer: Prime Health Services Commercial |
$97.67
|
|
|
HC TUBE NASOGASTRIC 10FR W/STYLET
|
Facility
OP
|
$114.91
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.98 |
| Max. Negotiated Rate |
$103.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$97.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$63.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$63.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.89
|
| Rate for Payer: BCBS Transplant Transplant |
$68.95
|
| Rate for Payer: Blue Shield of California Commercial |
$72.28
|
| Rate for Payer: Blue Shield of California EPN |
$56.19
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Central Health Plan Commercial |
$91.93
|
| Rate for Payer: Cigna of CA HMO |
$73.54
|
| Rate for Payer: Cigna of CA PPO |
$85.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.96
|
| Rate for Payer: Galaxy Health WC |
$97.67
|
| Rate for Payer: Global Benefits Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.42
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$86.18
|
| Rate for Payer: IEHP medi-cal |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.98
|
| Rate for Payer: Multiplan Commercial |
$86.18
|
| Rate for Payer: Networks By Design Commercial |
$74.69
|
| Rate for Payer: Prime Health Services Commercial |
$97.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$68.95
|
| Rate for Payer: Riverside University Health MISP |
$45.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.46
|
| Rate for Payer: United Healthcare All Other HMO |
$57.46
|
| Rate for Payer: United Healthcare HMO Rider |
$57.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.67
|
| Rate for Payer: Vantage Medical Group Senior |
$97.67
|
|
|
HC TUBE NASOGASTRIC 6FR DIA 22"
|
Facility
IP
|
$88.77
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Central Health Plan Commercial |
$71.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.51
|
| Rate for Payer: Galaxy Health WC |
$75.45
|
| Rate for Payer: Global Benefits Group Commercial |
$53.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$66.58
|
| Rate for Payer: Networks By Design Commercial |
$57.70
|
| Rate for Payer: Prime Health Services Commercial |
$75.45
|
|
|
HC TUBE NASOGASTRIC 6FR DIA 22"
|
Facility
OP
|
$88.77
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$79.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$75.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$48.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$48.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.45
|
| Rate for Payer: BCBS Transplant Transplant |
$53.26
|
| Rate for Payer: Blue Shield of California Commercial |
$55.84
|
| Rate for Payer: Blue Shield of California EPN |
$43.41
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Central Health Plan Commercial |
$71.02
|
| Rate for Payer: Cigna of CA HMO |
$56.81
|
| Rate for Payer: Cigna of CA PPO |
$65.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.51
|
| Rate for Payer: Galaxy Health WC |
$75.45
|
| Rate for Payer: Global Benefits Group Commercial |
$53.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.89
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$66.58
|
| Rate for Payer: IEHP medi-cal |
$31.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$66.58
|
| Rate for Payer: Networks By Design Commercial |
$57.70
|
| Rate for Payer: Prime Health Services Commercial |
$75.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$53.26
|
| Rate for Payer: Riverside University Health MISP |
$35.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.38
|
| Rate for Payer: United Healthcare All Other HMO |
$44.38
|
| Rate for Payer: United Healthcare HMO Rider |
$44.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.45
|
| Rate for Payer: Vantage Medical Group Senior |
$75.45
|
|
|
HC TUBE NASOGASTRIC 6FR DUAL
|
Facility
OP
|
$110.58
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.12 |
| Max. Negotiated Rate |
$99.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$93.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$60.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$60.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.33
|
| Rate for Payer: BCBS Transplant Transplant |
$66.35
|
| Rate for Payer: Blue Shield of California Commercial |
$69.55
|
| Rate for Payer: Blue Shield of California EPN |
$54.07
|
| Rate for Payer: Cash Price |
$49.76
|
| Rate for Payer: Cash Price |
$49.76
|
| Rate for Payer: Central Health Plan Commercial |
$88.46
|
| Rate for Payer: Cigna of CA HMO |
$70.77
|
| Rate for Payer: Cigna of CA PPO |
$81.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$44.23
|
| Rate for Payer: Galaxy Health WC |
$93.99
|
| Rate for Payer: Global Benefits Group Commercial |
$66.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.52
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$82.94
|
| Rate for Payer: IEHP medi-cal |
$38.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.12
|
| Rate for Payer: Multiplan Commercial |
$82.94
|
| Rate for Payer: Networks By Design Commercial |
$71.88
|
| Rate for Payer: Prime Health Services Commercial |
$93.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$66.35
|
| Rate for Payer: Riverside University Health MISP |
$44.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.29
|
| Rate for Payer: United Healthcare All Other HMO |
$55.29
|
| Rate for Payer: United Healthcare HMO Rider |
$55.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.99
|
| Rate for Payer: Vantage Medical Group Senior |
$93.99
|
|
|
HC TUBE NASOGASTRIC 6FR DUAL
|
Facility
IP
|
$110.58
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.12 |
| Max. Negotiated Rate |
$99.52 |
| Rate for Payer: Cash Price |
$49.76
|
| Rate for Payer: Central Health Plan Commercial |
$88.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.23
|
| Rate for Payer: Galaxy Health WC |
$93.99
|
| Rate for Payer: Global Benefits Group Commercial |
$66.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.12
|
| Rate for Payer: Multiplan Commercial |
$82.94
|
| Rate for Payer: Networks By Design Commercial |
$71.88
|
| Rate for Payer: Prime Health Services Commercial |
$93.99
|
|
|
HC TUBE NASOGASTRIC CO2 12FR
|
Facility
OP
|
$114.00
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$96.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$62.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.35
|
| Rate for Payer: BCBS Transplant Transplant |
$68.40
|
| Rate for Payer: Blue Shield of California Commercial |
$71.71
|
| Rate for Payer: Blue Shield of California EPN |
$55.75
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Central Health Plan Commercial |
$91.20
|
| Rate for Payer: Cigna of CA HMO |
$72.96
|
| Rate for Payer: Cigna of CA PPO |
$84.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.60
|
| Rate for Payer: Galaxy Health WC |
$96.90
|
| Rate for Payer: Global Benefits Group Commercial |
$68.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$85.50
|
| Rate for Payer: IEHP medi-cal |
$39.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.80
|
| Rate for Payer: Multiplan Commercial |
$85.50
|
| Rate for Payer: Networks By Design Commercial |
$74.10
|
| Rate for Payer: Prime Health Services Commercial |
$96.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$68.40
|
| Rate for Payer: Riverside University Health MISP |
$45.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.00
|
| Rate for Payer: United Healthcare All Other HMO |
$57.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.90
|
| Rate for Payer: Vantage Medical Group Senior |
$96.90
|
|
|
HC TUBE NASOGASTRIC CO2 12FR
|
Facility
IP
|
$114.00
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901698619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Central Health Plan Commercial |
$91.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.60
|
| Rate for Payer: Galaxy Health WC |
$96.90
|
| Rate for Payer: Global Benefits Group Commercial |
$68.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.80
|
| Rate for Payer: Multiplan Commercial |
$85.50
|
| Rate for Payer: Networks By Design Commercial |
$74.10
|
| Rate for Payer: Prime Health Services Commercial |
$96.90
|
|
|
HC TUBE NASOGASTRIC CORTRAK EAS 10FR 55"
|
Facility
IP
|
$350.73
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901606423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.15 |
| Max. Negotiated Rate |
$315.66 |
| Rate for Payer: Cash Price |
$157.83
|
| Rate for Payer: Central Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.29
|
| Rate for Payer: Galaxy Health WC |
$298.12
|
| Rate for Payer: Global Benefits Group Commercial |
$210.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.15
|
| Rate for Payer: Multiplan Commercial |
$263.05
|
| Rate for Payer: Networks By Design Commercial |
$227.97
|
| Rate for Payer: Prime Health Services Commercial |
$298.12
|
|
|
HC TUBE NASOGASTRIC CORTRAK EAS 10FR 55"
|
Facility
OP
|
$350.73
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901606423
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$315.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$298.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.21
|
| Rate for Payer: BCBS Transplant Transplant |
$210.44
|
| Rate for Payer: Blue Shield of California Commercial |
$220.61
|
| Rate for Payer: Blue Shield of California EPN |
$171.51
|
| Rate for Payer: Cash Price |
$157.83
|
| Rate for Payer: Cash Price |
$157.83
|
| Rate for Payer: Central Health Plan Commercial |
$280.58
|
| Rate for Payer: Cigna of CA HMO |
$224.47
|
| Rate for Payer: Cigna of CA PPO |
$259.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.29
|
| Rate for Payer: Galaxy Health WC |
$298.12
|
| Rate for Payer: Global Benefits Group Commercial |
$210.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$263.05
|
| Rate for Payer: IEHP medi-cal |
$122.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.15
|
| Rate for Payer: Multiplan Commercial |
$263.05
|
| Rate for Payer: Networks By Design Commercial |
$227.97
|
| Rate for Payer: Prime Health Services Commercial |
$298.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.44
|
| Rate for Payer: Riverside University Health MISP |
$140.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.36
|
| Rate for Payer: United Healthcare All Other HMO |
$175.36
|
| Rate for Payer: United Healthcare HMO Rider |
$175.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$298.12
|
| Rate for Payer: Vantage Medical Group Senior |
$298.12
|
|
|
HC TUBE PLACEMENT/GASTROINTESTINA
|
Facility
OP
|
$1,092.00
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
909001835
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$982.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$452.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$928.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$600.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$600.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$545.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$665.26
|
| Rate for Payer: BCBS Transplant Transplant |
$655.20
|
| Rate for Payer: Blue Shield of California Commercial |
$674.86
|
| Rate for Payer: Blue Shield of California EPN |
$530.71
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Central Health Plan Commercial |
$873.60
|
| Rate for Payer: Cigna of CA HMO |
$698.88
|
| Rate for Payer: Cigna of CA PPO |
$808.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$928.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$436.80
|
| Rate for Payer: Galaxy Health WC |
$928.20
|
| Rate for Payer: Global Benefits Group Commercial |
$655.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$982.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$819.00
|
| Rate for Payer: IEHP medi-cal |
$382.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$728.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.40
|
| Rate for Payer: Multiplan Commercial |
$819.00
|
| Rate for Payer: Networks By Design Commercial |
$709.80
|
| Rate for Payer: Prime Health Services Commercial |
$928.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$655.20
|
| Rate for Payer: Riverside University Health MISP |
$436.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$655.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$655.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$546.00
|
| Rate for Payer: United Healthcare All Other HMO |
$546.00
|
| Rate for Payer: United Healthcare HMO Rider |
$546.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$546.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$928.20
|
| Rate for Payer: Vantage Medical Group Senior |
$928.20
|
|
