|
HC TUBE PLACEMENT/GASTROINTESTINA
|
Facility
IP
|
$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: Cash Price |
$491.40
|
| Rate for Payer: Central Health Plan Commercial |
$873.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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
|
|
|
HC TUBE QUICKTRACH PEDS
|
Facility
OP
|
$817.70
|
|
| Hospital Charge Code |
901604150
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$286.20 |
| Max. Negotiated Rate |
$735.93 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$695.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$449.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$449.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$395.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$483.10
|
| Rate for Payer: BCBS Transplant Transplant |
$490.62
|
| Rate for Payer: Blue Shield of California Commercial |
$613.28
|
| Rate for Payer: Blue Shield of California EPN |
$444.83
|
| Rate for Payer: Cash Price |
$367.97
|
| Rate for Payer: Cash Price |
$367.97
|
| Rate for Payer: Central Health Plan Commercial |
$654.16
|
| Rate for Payer: Cigna of CA HMO |
$572.39
|
| Rate for Payer: Cigna of CA PPO |
$572.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$695.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$327.08
|
| Rate for Payer: Galaxy Health WC |
$695.04
|
| Rate for Payer: Global Benefits Group Commercial |
$490.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$735.93
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$613.28
|
| Rate for Payer: IEHP medi-cal |
$286.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.26
|
| Rate for Payer: Multiplan Commercial |
$613.28
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$695.04
|
| Rate for Payer: Riverside University Health MISP |
$327.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$490.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$490.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$408.85
|
| Rate for Payer: United Healthcare All Other HMO |
$408.85
|
| Rate for Payer: United Healthcare HMO Rider |
$408.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$408.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$695.04
|
| Rate for Payer: Vantage Medical Group Senior |
$695.04
|
|
|
HC TUBE QUICKTRACH PEDS
|
Facility
IP
|
$817.70
|
|
| Hospital Charge Code |
901604150
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$163.54 |
| Max. Negotiated Rate |
$735.93 |
| Rate for Payer: Blue Shield of California EPN |
$436.65
|
| Rate for Payer: Cash Price |
$367.97
|
| Rate for Payer: Central Health Plan Commercial |
$654.16
|
| Rate for Payer: Cigna of CA HMO |
$572.39
|
| Rate for Payer: Cigna of CA PPO |
$572.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$327.08
|
| Rate for Payer: Galaxy Health WC |
$695.04
|
| Rate for Payer: Global Benefits Group Commercial |
$490.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$735.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.54
|
| Rate for Payer: Multiplan Commercial |
$613.28
|
| Rate for Payer: Networks By Design Commercial |
$408.85
|
| Rate for Payer: Prime Health Services Commercial |
$695.04
|
|
|
HC TUBE SALEM SUMP 10FR
|
Facility
OP
|
$11.81
|
|
| Hospital Charge Code |
901698289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$10.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.98
|
| Rate for Payer: BCBS Transplant Transplant |
$7.09
|
| Rate for Payer: Blue Shield of California Commercial |
$7.43
|
| Rate for Payer: Blue Shield of California EPN |
$5.78
|
| Rate for Payer: Cash Price |
$5.31
|
| Rate for Payer: Central Health Plan Commercial |
$9.45
|
| Rate for Payer: Cigna of CA HMO |
$7.56
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.72
|
| Rate for Payer: Galaxy Health WC |
$10.04
|
| Rate for Payer: Global Benefits Group Commercial |
$7.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.63
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.86
|
| Rate for Payer: IEHP medi-cal |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.36
|
| Rate for Payer: Multiplan Commercial |
$8.86
|
| Rate for Payer: Networks By Design Commercial |
$7.68
|
| Rate for Payer: Prime Health Services Commercial |
$10.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.09
|
| Rate for Payer: Riverside University Health MISP |
$4.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.90
|
| Rate for Payer: United Healthcare All Other HMO |
$5.90
|
| Rate for Payer: United Healthcare HMO Rider |
$5.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.04
|
| Rate for Payer: Vantage Medical Group Senior |
$10.04
|
|
|
HC TUBE SALEM SUMP 10FR
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901605446
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE SALEM SUMP 10FR
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901605446
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE SALEM SUMP 10FR
|
Facility
IP
|
$11.81
|
|
| Hospital Charge Code |
901698289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$10.63 |
| Rate for Payer: Cash Price |
$5.31
|
| Rate for Payer: Central Health Plan Commercial |
$9.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.72
|
| Rate for Payer: Galaxy Health WC |
$10.04
|
| Rate for Payer: Global Benefits Group Commercial |
$7.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.36
|
| Rate for Payer: Multiplan Commercial |
$8.86
|
| Rate for Payer: Networks By Design Commercial |
$7.68
|
| Rate for Payer: Prime Health Services Commercial |
$10.04
|
|
|
HC TUBE SALEM SUMP 12FR
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901605445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE SALEM SUMP 12FR
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901605445
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE SALEM SUMP 12FR 48"
|
Facility
OP
|
$26.16
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$45.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.46
|
| Rate for Payer: BCBS Transplant Transplant |
$15.70
|
| Rate for Payer: Blue Shield of California Commercial |
$16.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.79
|
| Rate for Payer: Cash Price |
$11.77
|
| Rate for Payer: Cash Price |
$11.77
|
| Rate for Payer: Central Health Plan Commercial |
$20.93
|
| Rate for Payer: Cigna of CA HMO |
$16.74
|
| Rate for Payer: Cigna of CA PPO |
$19.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.46
|
| Rate for Payer: Galaxy Health WC |
$22.24
|
| Rate for Payer: Global Benefits Group Commercial |
$15.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.54
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.62
|
| Rate for Payer: IEHP medi-cal |
$9.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.23
|
| Rate for Payer: Multiplan Commercial |
$19.62
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$22.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.70
|
| Rate for Payer: Riverside University Health MISP |
$10.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.08
|
| Rate for Payer: United Healthcare All Other HMO |
$13.08
|
| Rate for Payer: United Healthcare HMO Rider |
$13.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.24
|
| Rate for Payer: Vantage Medical Group Senior |
$22.24
|
|
|
HC TUBE SALEM SUMP 12FR 48"
|
Facility
IP
|
$26.16
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$23.54 |
| Rate for Payer: Cash Price |
$11.77
|
| Rate for Payer: Central Health Plan Commercial |
$20.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.46
|
| Rate for Payer: Galaxy Health WC |
$22.24
|
| Rate for Payer: Global Benefits Group Commercial |
$15.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.23
|
| Rate for Payer: Multiplan Commercial |
$19.62
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$22.24
|
|
|
HC TUBE SALEM SUMP 14FR
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901605444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE SALEM SUMP 14FR
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901605444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE SALEM SUMP 16FR
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901605443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE SALEM SUMP 16FR
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901605443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE SALEM SUMP 16FR X 48IN
|
Facility
IP
|
$18.04
|
|
| Hospital Charge Code |
901698261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
|
|
HC TUBE SALEM SUMP 16FR X 48IN
|
Facility
OP
|
$18.04
|
|
| Hospital Charge Code |
901698261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.66
|
| Rate for Payer: BCBS Transplant Transplant |
$10.82
|
| Rate for Payer: Blue Shield of California Commercial |
$11.35
|
| Rate for Payer: Blue Shield of California EPN |
$8.82
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$11.55
|
| Rate for Payer: Cigna of CA PPO |
$13.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.53
|
| Rate for Payer: IEHP medi-cal |
$6.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: Riverside University Health MISP |
$7.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.02
|
| Rate for Payer: United Healthcare All Other HMO |
$9.02
|
| Rate for Payer: United Healthcare HMO Rider |
$9.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.33
|
| Rate for Payer: Vantage Medical Group Senior |
$15.33
|
|
|
HC TUBE SALEM SUMP 18FR
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901605442
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE SALEM SUMP 18FR
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901605442
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE SALEM SUMP 18FR X 48IN
|
Facility
OP
|
$11.64
|
|
| Hospital Charge Code |
901698262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$10.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.88
|
| Rate for Payer: BCBS Transplant Transplant |
$6.98
|
| Rate for Payer: Blue Shield of California Commercial |
$7.32
|
| Rate for Payer: Blue Shield of California EPN |
$5.69
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Central Health Plan Commercial |
$9.31
|
| Rate for Payer: Cigna of CA HMO |
$7.45
|
| Rate for Payer: Cigna of CA PPO |
$8.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.66
|
| Rate for Payer: Galaxy Health WC |
$9.89
|
| Rate for Payer: Global Benefits Group Commercial |
$6.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.48
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.73
|
| Rate for Payer: IEHP medi-cal |
$4.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.33
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.57
|
| Rate for Payer: Prime Health Services Commercial |
$9.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.98
|
| Rate for Payer: Riverside University Health MISP |
$4.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.82
|
| Rate for Payer: United Healthcare All Other HMO |
$5.82
|
| Rate for Payer: United Healthcare HMO Rider |
$5.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.89
|
| Rate for Payer: Vantage Medical Group Senior |
$9.89
|
|
|
HC TUBE SALEM SUMP 18FR X 48IN
|
Facility
IP
|
$11.64
|
|
| Hospital Charge Code |
901698262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$10.48 |
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Central Health Plan Commercial |
$9.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.66
|
| Rate for Payer: Galaxy Health WC |
$9.89
|
| Rate for Payer: Global Benefits Group Commercial |
$6.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.33
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.57
|
| Rate for Payer: Prime Health Services Commercial |
$9.89
|
|
|
HC TUBE SALEM SUMP 8FR PVC
|
Facility
IP
|
$58.71
|
|
| Hospital Charge Code |
901698318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Cash Price |
$26.42
|
| Rate for Payer: Central Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.48
|
| Rate for Payer: Galaxy Health WC |
$49.90
|
| Rate for Payer: Global Benefits Group Commercial |
$35.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.74
|
| Rate for Payer: Multiplan Commercial |
$44.03
|
| Rate for Payer: Networks By Design Commercial |
$38.16
|
| Rate for Payer: Prime Health Services Commercial |
$49.90
|
|
|
HC TUBE SALEM SUMP 8FR PVC
|
Facility
OP
|
$58.71
|
|
| Hospital Charge Code |
901698318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$52.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35.65
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$49.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$32.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.69
|
| Rate for Payer: BCBS Transplant Transplant |
$35.23
|
| Rate for Payer: Blue Shield of California Commercial |
$36.93
|
| Rate for Payer: Blue Shield of California EPN |
$28.71
|
| Rate for Payer: Cash Price |
$26.42
|
| Rate for Payer: Central Health Plan Commercial |
$46.97
|
| Rate for Payer: Cigna of CA HMO |
$37.57
|
| Rate for Payer: Cigna of CA PPO |
$43.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.48
|
| Rate for Payer: Galaxy Health WC |
$49.90
|
| Rate for Payer: Global Benefits Group Commercial |
$35.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.84
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$44.03
|
| Rate for Payer: IEHP medi-cal |
$20.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.74
|
| Rate for Payer: Multiplan Commercial |
$44.03
|
| Rate for Payer: Networks By Design Commercial |
$38.16
|
| Rate for Payer: Prime Health Services Commercial |
$49.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$35.23
|
| Rate for Payer: Riverside University Health MISP |
$23.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.36
|
| Rate for Payer: United Healthcare All Other HMO |
$29.36
|
| Rate for Payer: United Healthcare HMO Rider |
$29.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.90
|
| Rate for Payer: Vantage Medical Group Senior |
$49.90
|
|
|
HC TUBE SALEM SUMP 8FR X 48"
|
Facility
IP
|
$41.25
|
|
| Hospital Charge Code |
901602993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
|
|
HC TUBE SALEM SUMP 8FR X 48"
|
Facility
OP
|
$41.25
|
|
| Hospital Charge Code |
901602993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.37
|
| Rate for Payer: BCBS Transplant Transplant |
$24.75
|
| Rate for Payer: Blue Shield of California Commercial |
$25.95
|
| Rate for Payer: Blue Shield of California EPN |
$20.17
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: Cigna of CA HMO |
$26.40
|
| Rate for Payer: Cigna of CA PPO |
$30.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.94
|
| Rate for Payer: IEHP medi-cal |
$14.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: Riverside University Health MISP |
$16.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.06
|
| Rate for Payer: Vantage Medical Group Senior |
$35.06
|
|
