|
HC URIC ACID URINE
|
Facility
IP
|
$112.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900910216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC URIC ACID URINE
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900910216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$42.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.12
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.08
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.33
|
| Rate for Payer: IEHP medi-cal |
$8.38
|
| Rate for Payer: IEHP Medicare Advantage |
$5.08
|
| Rate for Payer: Innovage PACE Commercial |
$7.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.81
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$5.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$5.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.11
|
| Rate for Payer: United Healthcare HMO Rider |
$4.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.08
|
|
|
HC URIC ACID URINE 24 HOURS
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900912223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$42.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.12
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.08
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.33
|
| Rate for Payer: IEHP medi-cal |
$8.38
|
| Rate for Payer: IEHP Medicare Advantage |
$5.08
|
| Rate for Payer: Innovage PACE Commercial |
$7.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.81
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$5.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$5.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.11
|
| Rate for Payer: United Healthcare HMO Rider |
$4.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.08
|
|
|
HC URIC ACID URINE 24 HOURS
|
Facility
IP
|
$112.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900912223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC URIC ACID URINE RANDOM
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900912222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$42.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.12
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.08
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.33
|
| Rate for Payer: IEHP medi-cal |
$8.38
|
| Rate for Payer: IEHP Medicare Advantage |
$5.08
|
| Rate for Payer: Innovage PACE Commercial |
$7.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.81
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$5.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$5.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.11
|
| Rate for Payer: United Healthcare HMO Rider |
$4.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.08
|
|
|
HC URIC ACID URINE RANDOM
|
Facility
IP
|
$112.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900912222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
OP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
906581002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.09
|
| Rate for Payer: BCBS Transplant Transplant |
$82.20
|
| Rate for Payer: Blue Shield of California Commercial |
$84.67
|
| Rate for Payer: Blue Shield of California EPN |
$66.58
|
| Rate for Payer: Caremore Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$87.68
|
| Rate for Payer: Cigna of CA PPO |
$101.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$102.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: IEHP medi-cal |
$5.74
|
| Rate for Payer: IEHP Medicare Advantage |
$3.48
|
| Rate for Payer: Innovage PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: Riverside University Health MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
OP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.09
|
| Rate for Payer: BCBS Transplant Transplant |
$82.20
|
| Rate for Payer: Blue Shield of California Commercial |
$84.67
|
| Rate for Payer: Blue Shield of California EPN |
$66.58
|
| Rate for Payer: Caremore Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$87.68
|
| Rate for Payer: Cigna of CA PPO |
$101.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$102.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: IEHP medi-cal |
$5.74
|
| Rate for Payer: IEHP Medicare Advantage |
$3.48
|
| Rate for Payer: Innovage PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: Riverside University Health MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
906581002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
OP
|
$137.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.09
|
| Rate for Payer: BCBS Transplant Transplant |
$82.20
|
| Rate for Payer: Blue Shield of California Commercial |
$84.67
|
| Rate for Payer: Blue Shield of California EPN |
$66.58
|
| Rate for Payer: Caremore Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$87.68
|
| Rate for Payer: Cigna of CA PPO |
$101.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$102.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: IEHP medi-cal |
$5.74
|
| Rate for Payer: IEHP Medicare Advantage |
$3.48
|
| Rate for Payer: Innovage PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: Riverside University Health MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
IP
|
$122.06
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Central Health Plan Commercial |
$97.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.82
|
| Rate for Payer: Galaxy Health WC |
$103.75
|
| Rate for Payer: Global Benefits Group Commercial |
$73.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$91.54
|
| Rate for Payer: Networks By Design Commercial |
$79.34
|
| Rate for Payer: Prime Health Services Commercial |
$103.75
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
OP
|
$122.06
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$103.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$67.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$67.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.11
|
| Rate for Payer: BCBS Transplant Transplant |
$73.24
|
| Rate for Payer: Blue Shield of California Commercial |
$76.78
|
| Rate for Payer: Blue Shield of California EPN |
$59.69
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Central Health Plan Commercial |
$97.65
|
| Rate for Payer: Cigna of CA HMO |
$78.12
|
| Rate for Payer: Cigna of CA PPO |
$90.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$103.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$48.82
|
| Rate for Payer: Galaxy Health WC |
$103.75
|
| Rate for Payer: Global Benefits Group Commercial |
$73.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$109.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$91.54
|
| Rate for Payer: IEHP medi-cal |
$42.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$91.54
|
| Rate for Payer: Networks By Design Commercial |
$79.34
|
| Rate for Payer: Prime Health Services Commercial |
$103.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$73.24
|
| Rate for Payer: Riverside University Health MISP |
$48.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.03
|
| Rate for Payer: United Healthcare All Other HMO |
$61.03
|
| Rate for Payer: United Healthcare HMO Rider |
$61.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$103.75
|
| Rate for Payer: Vantage Medical Group Senior |
$103.75
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
OP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$75.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$71.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.39
|
| Rate for Payer: BCBS Transplant Transplant |
$50.16
|
| Rate for Payer: Blue Shield of California Commercial |
$52.58
|
| Rate for Payer: Blue Shield of California EPN |
$40.88
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Central Health Plan Commercial |
$66.88
|
| Rate for Payer: Cigna of CA HMO |
$53.50
|
| Rate for Payer: Cigna of CA PPO |
$61.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$62.70
|
| Rate for Payer: IEHP medi-cal |
$29.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.72
|
| Rate for Payer: Multiplan Commercial |
$62.70
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$50.16
|
| Rate for Payer: Riverside University Health MISP |
$33.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.80
|
| Rate for Payer: United Healthcare All Other HMO |
$41.80
|
| Rate for Payer: United Healthcare HMO Rider |
$41.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.06
|
| Rate for Payer: Vantage Medical Group Senior |
$71.06
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
IP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$75.24 |
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Central Health Plan Commercial |
$66.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.72
|
| Rate for Payer: Multiplan Commercial |
$62.70
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
OP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$119.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$107.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.80
|
| Rate for Payer: BCBS Transplant Transplant |
$117.60
|
| Rate for Payer: Blue Shield of California Commercial |
$123.28
|
| Rate for Payer: Blue Shield of California EPN |
$95.84
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$147.00
|
| Rate for Payer: IEHP medi-cal |
$68.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: Riverside University Health MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
IP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
IP
|
$220.22
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Cash Price |
$99.10
|
| Rate for Payer: Central Health Plan Commercial |
$176.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.09
|
| Rate for Payer: Galaxy Health WC |
$187.19
|
| Rate for Payer: Global Benefits Group Commercial |
$132.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.04
|
| Rate for Payer: Multiplan Commercial |
$165.16
|
| Rate for Payer: Networks By Design Commercial |
$143.14
|
| Rate for Payer: Prime Health Services Commercial |
$187.19
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
OP
|
$220.22
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$133.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$187.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$121.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$121.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.11
|
| Rate for Payer: BCBS Transplant Transplant |
$132.13
|
| Rate for Payer: Blue Shield of California Commercial |
$138.52
|
| Rate for Payer: Blue Shield of California EPN |
$107.69
|
| Rate for Payer: Cash Price |
$99.10
|
| Rate for Payer: Central Health Plan Commercial |
$176.18
|
| Rate for Payer: Cigna of CA HMO |
$140.94
|
| Rate for Payer: Cigna of CA PPO |
$162.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$88.09
|
| Rate for Payer: Galaxy Health WC |
$187.19
|
| Rate for Payer: Global Benefits Group Commercial |
$132.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$165.16
|
| Rate for Payer: IEHP medi-cal |
$77.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.04
|
| Rate for Payer: Multiplan Commercial |
$165.16
|
| Rate for Payer: Networks By Design Commercial |
$143.14
|
| Rate for Payer: Prime Health Services Commercial |
$187.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: Riverside University Health MISP |
$88.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Vantage Medical Group Senior |
$187.19
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
IP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
OP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$119.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$107.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.80
|
| Rate for Payer: BCBS Transplant Transplant |
$117.60
|
| Rate for Payer: Blue Shield of California Commercial |
$123.28
|
| Rate for Payer: Blue Shield of California EPN |
$95.84
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$147.00
|
| Rate for Payer: IEHP medi-cal |
$68.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: Riverside University Health MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
OP
|
$220.22
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$133.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$187.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$121.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$121.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.11
|
| Rate for Payer: BCBS Transplant Transplant |
$132.13
|
| Rate for Payer: Blue Shield of California Commercial |
$138.52
|
| Rate for Payer: Blue Shield of California EPN |
$107.69
|
| Rate for Payer: Cash Price |
$99.10
|
| Rate for Payer: Central Health Plan Commercial |
$176.18
|
| Rate for Payer: Cigna of CA HMO |
$140.94
|
| Rate for Payer: Cigna of CA PPO |
$162.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$88.09
|
| Rate for Payer: Galaxy Health WC |
$187.19
|
| Rate for Payer: Global Benefits Group Commercial |
$132.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$165.16
|
| Rate for Payer: IEHP medi-cal |
$77.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.04
|
| Rate for Payer: Multiplan Commercial |
$165.16
|
| Rate for Payer: Networks By Design Commercial |
$143.14
|
| Rate for Payer: Prime Health Services Commercial |
$187.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: Riverside University Health MISP |
$88.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Vantage Medical Group Senior |
$187.19
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
IP
|
$220.22
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Cash Price |
$99.10
|
| Rate for Payer: Central Health Plan Commercial |
$176.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.09
|
| Rate for Payer: Galaxy Health WC |
$187.19
|
| Rate for Payer: Global Benefits Group Commercial |
$132.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.04
|
| Rate for Payer: Multiplan Commercial |
$165.16
|
| Rate for Payer: Networks By Design Commercial |
$143.14
|
| Rate for Payer: Prime Health Services Commercial |
$187.19
|
|
|
HC URINARY DRAIN SET CATH 8FR
|
Facility
OP
|
$220.22
|
|
| Hospital Charge Code |
901698512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.04 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$133.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$187.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$121.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$121.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.11
|
| Rate for Payer: BCBS Transplant Transplant |
$132.13
|
| Rate for Payer: Blue Shield of California Commercial |
$138.52
|
| Rate for Payer: Blue Shield of California EPN |
$107.69
|
| Rate for Payer: Cash Price |
$99.10
|
| Rate for Payer: Central Health Plan Commercial |
$176.18
|
| Rate for Payer: Cigna of CA HMO |
$140.94
|
| Rate for Payer: Cigna of CA PPO |
$162.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$88.09
|
| Rate for Payer: Galaxy Health WC |
$187.19
|
| Rate for Payer: Global Benefits Group Commercial |
$132.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$165.16
|
| Rate for Payer: IEHP medi-cal |
$77.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.04
|
| Rate for Payer: Multiplan Commercial |
$165.16
|
| Rate for Payer: Networks By Design Commercial |
$143.14
|
| Rate for Payer: Prime Health Services Commercial |
$187.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: Riverside University Health MISP |
$88.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Vantage Medical Group Senior |
$187.19
|
|
