|
HC TUBE FEEDING 5FR 22" W/STYLET
|
Facility
|
OP
|
$114.61
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$103.15 |
| Rate for Payer: Adventist Health Commercial |
$22.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$97.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.31
|
| Rate for Payer: Blue Shield of California Commercial |
$70.03
|
| Rate for Payer: Blue Shield of California EPN |
$45.73
|
| Rate for Payer: Cash Price |
$63.04
|
| Rate for Payer: Central Health Plan Commercial |
$91.69
|
| Rate for Payer: Cigna of CA HMO |
$73.35
|
| Rate for Payer: Cigna of CA PPO |
$84.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$97.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$97.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.84
|
| Rate for Payer: EPIC Health Plan Senior |
$45.84
|
| Rate for Payer: Galaxy Health WC |
$97.42
|
| Rate for Payer: Global Benefits Group Commercial |
$68.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.15
|
| Rate for Payer: InnovAge PACE Commercial |
$57.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80.23
|
| Rate for Payer: Multiplan Commercial |
$85.96
|
| Rate for Payer: Networks By Design Commercial |
$74.50
|
| Rate for Payer: Prime Health Services Commercial |
$97.42
|
| Rate for Payer: Riverside University Health System MISP |
$45.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.30
|
| Rate for Payer: United Healthcare All Other HMO |
$57.30
|
| Rate for Payer: United Healthcare HMO Rider |
$57.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$97.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.42
|
| Rate for Payer: Vantage Medical Group Senior |
$97.42
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
IP
|
$120.46
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$108.41 |
| Rate for Payer: Adventist Health Commercial |
$24.09
|
| Rate for Payer: Cash Price |
$66.25
|
| Rate for Payer: Central Health Plan Commercial |
$96.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.18
|
| Rate for Payer: EPIC Health Plan Senior |
$48.18
|
| Rate for Payer: Galaxy Health WC |
$102.39
|
| Rate for Payer: Global Benefits Group Commercial |
$72.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.09
|
| Rate for Payer: Multiplan Commercial |
$90.34
|
| Rate for Payer: Networks By Design Commercial |
$78.30
|
| Rate for Payer: Prime Health Services Commercial |
$102.39
|
|
|
HC TUBE FEEDING 6FR 36" WEIGHTED
|
Facility
|
OP
|
$120.46
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$108.41 |
| Rate for Payer: Adventist Health Commercial |
$24.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.75
|
| Rate for Payer: Blue Shield of California Commercial |
$73.60
|
| Rate for Payer: Blue Shield of California EPN |
$48.06
|
| Rate for Payer: Cash Price |
$66.25
|
| Rate for Payer: Central Health Plan Commercial |
$96.37
|
| Rate for Payer: Cigna of CA HMO |
$77.09
|
| Rate for Payer: Cigna of CA PPO |
$89.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.18
|
| Rate for Payer: EPIC Health Plan Senior |
$48.18
|
| Rate for Payer: Galaxy Health WC |
$102.39
|
| Rate for Payer: Global Benefits Group Commercial |
$72.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.41
|
| Rate for Payer: InnovAge PACE Commercial |
$60.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84.32
|
| Rate for Payer: Multiplan Commercial |
$90.34
|
| Rate for Payer: Networks By Design Commercial |
$78.30
|
| Rate for Payer: Prime Health Services Commercial |
$102.39
|
| Rate for Payer: Riverside University Health System MISP |
$48.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.23
|
| Rate for Payer: United Healthcare All Other HMO |
$60.23
|
| Rate for Payer: United Healthcare HMO Rider |
$60.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.39
|
| Rate for Payer: Vantage Medical Group Senior |
$102.39
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
OP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.54
|
| Rate for Payer: Blue Shield of California Commercial |
$61.94
|
| Rate for Payer: Blue Shield of California EPN |
$40.45
|
| Rate for Payer: Cash Price |
$55.76
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Cigna of CA HMO |
$64.88
|
| Rate for Payer: Cigna of CA PPO |
$75.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: InnovAge PACE Commercial |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$70.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70.97
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
| Rate for Payer: Riverside University Health System MISP |
$40.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.69
|
| Rate for Payer: United Healthcare All Other HMO |
$50.69
|
| Rate for Payer: United Healthcare HMO Rider |
$50.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.17
|
| Rate for Payer: Vantage Medical Group Senior |
$86.17
|
|
|
HC TUBE FEEDING 6FR 36" W/STYLET
|
Facility
|
IP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Cash Price |
$55.76
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
OP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.54
|
| Rate for Payer: Blue Shield of California Commercial |
$61.94
|
| Rate for Payer: Blue Shield of California EPN |
$40.45
|
| Rate for Payer: Cash Price |
$55.76
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: Cigna of CA HMO |
$64.88
|
| Rate for Payer: Cigna of CA PPO |
$75.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: InnovAge PACE Commercial |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$70.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70.97
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
| Rate for Payer: Riverside University Health System MISP |
$40.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.69
|
| Rate for Payer: United Healthcare All Other HMO |
$50.69
|
| Rate for Payer: United Healthcare HMO Rider |
$50.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.17
|
| Rate for Payer: Vantage Medical Group Senior |
$86.17
|
|
|
HC TUBE FEEDING 8FR 36" W/STYLET
|
Facility
|
IP
|
$101.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901607621
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.28 |
| Max. Negotiated Rate |
$91.24 |
| Rate for Payer: Adventist Health Commercial |
$20.28
|
| Rate for Payer: Cash Price |
$55.76
|
| Rate for Payer: Central Health Plan Commercial |
$81.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.55
|
| Rate for Payer: EPIC Health Plan Senior |
$40.55
|
| Rate for Payer: Galaxy Health WC |
$86.17
|
| Rate for Payer: Global Benefits Group Commercial |
$60.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.28
|
| Rate for Payer: Multiplan Commercial |
$76.03
|
| Rate for Payer: Networks By Design Commercial |
$65.90
|
| Rate for Payer: Prime Health Services Commercial |
$86.17
|
|
|
HC TUBE FEEDING 8FR W/O STYLET
|
Facility
|
IP
|
$32.80
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$29.52 |
| Rate for Payer: Adventist Health Commercial |
$6.56
|
| Rate for Payer: Cash Price |
$18.04
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Senior |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
|
|
HC TUBE FEEDING 8FR W/O STYLET
|
Facility
|
OP
|
$32.80
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901698834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$29.52 |
| Rate for Payer: Adventist Health Commercial |
$6.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.26
|
| Rate for Payer: Blue Shield of California Commercial |
$20.04
|
| Rate for Payer: Blue Shield of California EPN |
$13.09
|
| Rate for Payer: Cash Price |
$18.04
|
| Rate for Payer: Central Health Plan Commercial |
$26.24
|
| Rate for Payer: Cigna of CA HMO |
$20.99
|
| Rate for Payer: Cigna of CA PPO |
$24.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Senior |
$13.12
|
| Rate for Payer: Galaxy Health WC |
$27.88
|
| Rate for Payer: Global Benefits Group Commercial |
$19.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.52
|
| Rate for Payer: InnovAge PACE Commercial |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.96
|
| Rate for Payer: Multiplan Commercial |
$24.60
|
| Rate for Payer: Networks By Design Commercial |
$21.32
|
| Rate for Payer: Prime Health Services Commercial |
$27.88
|
| Rate for Payer: Riverside University Health System MISP |
$13.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.40
|
| Rate for Payer: United Healthcare All Other HMO |
$16.40
|
| Rate for Payer: United Healthcare HMO Rider |
$16.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.88
|
| Rate for Payer: Vantage Medical Group Senior |
$27.88
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.16
|
| Rate for Payer: Blue Shield of California Commercial |
$50.10
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: InnovAge PACE Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC TUBE FEEDING 8FR X 16"
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901698572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC TUBE FEEDING ARGYLE 6.5FR, 16"
|
Facility
|
OP
|
$12.63
|
|
| Hospital Charge Code |
901607668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Adventist Health Commercial |
$2.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.42
|
| Rate for Payer: Blue Shield of California Commercial |
$7.72
|
| Rate for Payer: Blue Shield of California EPN |
$5.04
|
| Rate for Payer: Cash Price |
$6.95
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: Cigna of CA HMO |
$8.08
|
| Rate for Payer: Cigna of CA PPO |
$9.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: InnovAge PACE Commercial |
$6.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.84
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.32
|
| Rate for Payer: United Healthcare All Other HMO |
$6.32
|
| Rate for Payer: United Healthcare HMO Rider |
$6.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC TUBE FEEDING ARGYLE 6.5FR, 16"
|
Facility
|
IP
|
$12.63
|
|
| Hospital Charge Code |
901607668
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Adventist Health Commercial |
$2.53
|
| Rate for Payer: Cash Price |
$6.95
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
|
|
HC TUBE FEEDING ARGYLE 8FR, 16"
|
Facility
|
OP
|
$144.48
|
|
| Hospital Charge Code |
901607669
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.90 |
| Max. Negotiated Rate |
$130.03 |
| Rate for Payer: Adventist Health Commercial |
$28.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$122.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$79.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.85
|
| Rate for Payer: Blue Shield of California Commercial |
$88.28
|
| Rate for Payer: Blue Shield of California EPN |
$57.65
|
| Rate for Payer: Cash Price |
$79.46
|
| Rate for Payer: Central Health Plan Commercial |
$115.58
|
| Rate for Payer: Cigna of CA HMO |
$92.47
|
| Rate for Payer: Cigna of CA PPO |
$106.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$122.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$122.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.79
|
| Rate for Payer: EPIC Health Plan Senior |
$57.79
|
| Rate for Payer: Galaxy Health WC |
$122.81
|
| Rate for Payer: Global Benefits Group Commercial |
$86.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.03
|
| Rate for Payer: InnovAge PACE Commercial |
$72.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.14
|
| Rate for Payer: Multiplan Commercial |
$108.36
|
| Rate for Payer: Networks By Design Commercial |
$93.91
|
| Rate for Payer: Prime Health Services Commercial |
$122.81
|
| Rate for Payer: Riverside University Health System MISP |
$57.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.24
|
| Rate for Payer: United Healthcare All Other HMO |
$72.24
|
| Rate for Payer: United Healthcare HMO Rider |
$72.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$122.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$122.81
|
| Rate for Payer: Vantage Medical Group Senior |
$122.81
|
|
|
HC TUBE FEEDING ARGYLE 8FR, 16"
|
Facility
|
IP
|
$144.48
|
|
| Hospital Charge Code |
901607669
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.90 |
| Max. Negotiated Rate |
$130.03 |
| Rate for Payer: Adventist Health Commercial |
$28.90
|
| Rate for Payer: Cash Price |
$79.46
|
| Rate for Payer: Central Health Plan Commercial |
$115.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.79
|
| Rate for Payer: EPIC Health Plan Senior |
$57.79
|
| Rate for Payer: Galaxy Health WC |
$122.81
|
| Rate for Payer: Global Benefits Group Commercial |
$86.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.90
|
| Rate for Payer: Multiplan Commercial |
$108.36
|
| Rate for Payer: Networks By Design Commercial |
$93.91
|
| Rate for Payer: Prime Health Services Commercial |
$122.81
|
|
|
HC TUBE FEEDING CONTINUOUS GT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901602534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC TUBE FEEDING CONTINUOUS GT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901602534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.63
|
| Rate for Payer: Blue Shield of California Commercial |
$354.38
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC TUBE FEEDING CORFLO 5FR 22"
|
Facility
|
IP
|
$95.91
|
|
| Hospital Charge Code |
901605399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$86.32 |
| Rate for Payer: Adventist Health Commercial |
$19.18
|
| Rate for Payer: Cash Price |
$52.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.36
|
| Rate for Payer: EPIC Health Plan Senior |
$38.36
|
| Rate for Payer: Galaxy Health WC |
$81.52
|
| Rate for Payer: Global Benefits Group Commercial |
$57.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.18
|
| Rate for Payer: Multiplan Commercial |
$71.93
|
| Rate for Payer: Networks By Design Commercial |
$62.34
|
| Rate for Payer: Prime Health Services Commercial |
$81.52
|
|
|
HC TUBE FEEDING CORFLO 5FR 22"
|
Facility
|
OP
|
$95.91
|
|
| Hospital Charge Code |
901605399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$86.32 |
| Rate for Payer: Adventist Health Commercial |
$19.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.33
|
| Rate for Payer: Blue Shield of California Commercial |
$58.60
|
| Rate for Payer: Blue Shield of California EPN |
$38.27
|
| Rate for Payer: Cash Price |
$52.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.73
|
| Rate for Payer: Cigna of CA HMO |
$61.38
|
| Rate for Payer: Cigna of CA PPO |
$70.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.36
|
| Rate for Payer: EPIC Health Plan Senior |
$38.36
|
| Rate for Payer: Galaxy Health WC |
$81.52
|
| Rate for Payer: Global Benefits Group Commercial |
$57.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.32
|
| Rate for Payer: InnovAge PACE Commercial |
$47.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.14
|
| Rate for Payer: Multiplan Commercial |
$71.93
|
| Rate for Payer: Networks By Design Commercial |
$62.34
|
| Rate for Payer: Prime Health Services Commercial |
$81.52
|
| Rate for Payer: Riverside University Health System MISP |
$38.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.95
|
| Rate for Payer: United Healthcare All Other HMO |
$47.95
|
| Rate for Payer: United Healthcare HMO Rider |
$47.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.52
|
| Rate for Payer: Vantage Medical Group Senior |
$81.52
|
|
|
HC TUBE FEEDING CORFLO FR 36"
|
Facility
|
IP
|
$102.52
|
|
| Hospital Charge Code |
901605400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$92.27 |
| Rate for Payer: Adventist Health Commercial |
$20.50
|
| Rate for Payer: Cash Price |
$56.39
|
| Rate for Payer: Central Health Plan Commercial |
$82.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.01
|
| Rate for Payer: EPIC Health Plan Senior |
$41.01
|
| Rate for Payer: Galaxy Health WC |
$87.14
|
| Rate for Payer: Global Benefits Group Commercial |
$61.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: Multiplan Commercial |
$76.89
|
| Rate for Payer: Networks By Design Commercial |
$66.64
|
| Rate for Payer: Prime Health Services Commercial |
$87.14
|
|
|
HC TUBE FEEDING CORFLO FR 36"
|
Facility
|
OP
|
$102.52
|
|
| Hospital Charge Code |
901605400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$92.27 |
| Rate for Payer: Adventist Health Commercial |
$20.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.21
|
| Rate for Payer: Blue Shield of California Commercial |
$62.64
|
| Rate for Payer: Blue Shield of California EPN |
$40.91
|
| Rate for Payer: Cash Price |
$56.39
|
| Rate for Payer: Central Health Plan Commercial |
$82.02
|
| Rate for Payer: Cigna of CA HMO |
$65.61
|
| Rate for Payer: Cigna of CA PPO |
$75.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.01
|
| Rate for Payer: EPIC Health Plan Senior |
$41.01
|
| Rate for Payer: Galaxy Health WC |
$87.14
|
| Rate for Payer: Global Benefits Group Commercial |
$61.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.27
|
| Rate for Payer: InnovAge PACE Commercial |
$51.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.76
|
| Rate for Payer: Multiplan Commercial |
$76.89
|
| Rate for Payer: Networks By Design Commercial |
$66.64
|
| Rate for Payer: Prime Health Services Commercial |
$87.14
|
| Rate for Payer: Riverside University Health System MISP |
$41.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.26
|
| Rate for Payer: United Healthcare All Other HMO |
$51.26
|
| Rate for Payer: United Healthcare HMO Rider |
$51.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.14
|
| Rate for Payer: Vantage Medical Group Senior |
$87.14
|
|
|
HC TUBE FEEDING ENT 6 1/2FRX16"
|
Facility
|
OP
|
$73.55
|
|
| Hospital Charge Code |
901698725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.71 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Adventist Health Commercial |
$14.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$55.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.20
|
| Rate for Payer: Blue Shield of California Commercial |
$44.94
|
| Rate for Payer: Blue Shield of California EPN |
$29.35
|
| Rate for Payer: Cash Price |
$40.45
|
| Rate for Payer: Central Health Plan Commercial |
$58.84
|
| Rate for Payer: Cigna of CA HMO |
$47.07
|
| Rate for Payer: Cigna of CA PPO |
$54.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$62.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.42
|
| Rate for Payer: EPIC Health Plan Senior |
$29.42
|
| Rate for Payer: Galaxy Health WC |
$62.52
|
| Rate for Payer: Global Benefits Group Commercial |
$44.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.19
|
| Rate for Payer: InnovAge PACE Commercial |
$36.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51.48
|
| Rate for Payer: Multiplan Commercial |
$55.16
|
| Rate for Payer: Networks By Design Commercial |
$47.81
|
| Rate for Payer: Prime Health Services Commercial |
$62.52
|
| Rate for Payer: Riverside University Health System MISP |
$29.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$36.77
|
| Rate for Payer: United Healthcare All Other HMO |
$36.77
|
| Rate for Payer: United Healthcare HMO Rider |
$36.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.52
|
| Rate for Payer: Vantage Medical Group Senior |
$62.52
|
|
|
HC TUBE FEEDING ENT 6 1/2FRX16"
|
Facility
|
IP
|
$73.55
|
|
| Hospital Charge Code |
901698725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.71 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Adventist Health Commercial |
$14.71
|
| Rate for Payer: Cash Price |
$40.45
|
| Rate for Payer: Central Health Plan Commercial |
$58.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.42
|
| Rate for Payer: EPIC Health Plan Senior |
$29.42
|
| Rate for Payer: Galaxy Health WC |
$62.52
|
| Rate for Payer: Global Benefits Group Commercial |
$44.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.71
|
| Rate for Payer: Multiplan Commercial |
$55.16
|
| Rate for Payer: Networks By Design Commercial |
$47.81
|
| Rate for Payer: Prime Health Services Commercial |
$62.52
|
|
|
HC TUBE FEEDING ENTERAL 10FR 43"
|
Facility
|
OP
|
$95.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.02
|
| Rate for Payer: Blue Shield of California Commercial |
$58.28
|
| Rate for Payer: Blue Shield of California EPN |
$38.06
|
| Rate for Payer: Cash Price |
$52.46
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: InnovAge PACE Commercial |
$47.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.77
|
| Rate for Payer: Multiplan Commercial |
$71.53
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Riverside University Health System MISP |
$38.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC TUBE FEEDING ENTERAL 10FR 43"
|
Facility
|
IP
|
$95.38
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901600338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Cash Price |
$52.46
|
| Rate for Payer: Central Health Plan Commercial |
$76.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.08
|
| Rate for Payer: Multiplan Commercial |
$71.53
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
