|
HC YANKAUER BULB TIP VENT
|
Facility
OP
|
$3.77
|
|
|
Service Code
|
CPT A4628
|
| Hospital Charge Code |
901607940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.23
|
| Rate for Payer: BCBS Transplant Transplant |
$2.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2.37
|
| Rate for Payer: Blue Shield of California EPN |
$1.84
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Central Health Plan Commercial |
$3.02
|
| Rate for Payer: Cigna of CA HMO |
$2.41
|
| Rate for Payer: Cigna of CA PPO |
$2.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.51
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.39
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.83
|
| Rate for Payer: IEHP medi-cal |
$1.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$2.83
|
| Rate for Payer: Networks By Design Commercial |
$2.45
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.26
|
| Rate for Payer: Riverside University Health MISP |
$1.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.88
|
| Rate for Payer: United Healthcare All Other HMO |
$1.88
|
| Rate for Payer: United Healthcare HMO Rider |
$1.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3.20
|
|
|
HC YANKAUER BULB TIP VENT
|
Facility
IP
|
$3.77
|
|
|
Service Code
|
CPT A4628
|
| Hospital Charge Code |
901607940
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.39 |
| Rate for Payer: Cash Price |
$1.70
|
| Rate for Payer: Central Health Plan Commercial |
$3.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.51
|
| Rate for Payer: Galaxy Health WC |
$3.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$2.83
|
| Rate for Payer: Networks By Design Commercial |
$2.45
|
| Rate for Payer: Prime Health Services Commercial |
$3.20
|
|
|
HC YANKAUER FINE CAP FLANGE
|
Facility
IP
|
$4.59
|
|
| Hospital Charge Code |
901607936
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
|
|
HC YANKAUER FINE CAP FLANGE
|
Facility
OP
|
$4.59
|
|
| Hospital Charge Code |
901607936
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.71
|
| Rate for Payer: BCBS Transplant Transplant |
$2.75
|
| Rate for Payer: Blue Shield of California Commercial |
$2.89
|
| Rate for Payer: Blue Shield of California EPN |
$2.24
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$3.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.44
|
| Rate for Payer: IEHP medi-cal |
$1.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: Riverside University Health MISP |
$1.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.30
|
| Rate for Payer: United Healthcare All Other HMO |
$2.30
|
| Rate for Payer: United Healthcare HMO Rider |
$2.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3.90
|
|
|
HC YANKAUER FLANGE TIP FINE CAP
|
Facility
OP
|
$7.05
|
|
| Hospital Charge Code |
901698750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.17
|
| Rate for Payer: BCBS Transplant Transplant |
$4.23
|
| Rate for Payer: Blue Shield of California Commercial |
$4.43
|
| Rate for Payer: Blue Shield of California EPN |
$3.45
|
| Rate for Payer: Cash Price |
$3.17
|
| Rate for Payer: Central Health Plan Commercial |
$5.64
|
| Rate for Payer: Cigna of CA HMO |
$4.51
|
| Rate for Payer: Cigna of CA PPO |
$5.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.82
|
| Rate for Payer: Galaxy Health WC |
$5.99
|
| Rate for Payer: Global Benefits Group Commercial |
$4.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.29
|
| Rate for Payer: IEHP medi-cal |
$2.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.41
|
| Rate for Payer: Multiplan Commercial |
$5.29
|
| Rate for Payer: Networks By Design Commercial |
$4.58
|
| Rate for Payer: Prime Health Services Commercial |
$5.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.23
|
| Rate for Payer: Riverside University Health MISP |
$2.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.52
|
| Rate for Payer: United Healthcare All Other HMO |
$3.52
|
| Rate for Payer: United Healthcare HMO Rider |
$3.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.99
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
|
|
HC YANKAUER FLANGE TIP FINE CAP
|
Facility
IP
|
$7.05
|
|
| Hospital Charge Code |
901698750
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Cash Price |
$3.17
|
| Rate for Payer: Central Health Plan Commercial |
$5.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.82
|
| Rate for Payer: Galaxy Health WC |
$5.99
|
| Rate for Payer: Global Benefits Group Commercial |
$4.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.41
|
| Rate for Payer: Multiplan Commercial |
$5.29
|
| Rate for Payer: Networks By Design Commercial |
$4.58
|
| Rate for Payer: Prime Health Services Commercial |
$5.99
|
|
|
HC YANKAUER FLEX W/FLANGE TIP STL
|
Facility
OP
|
$4.59
|
|
| Hospital Charge Code |
901698717
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.71
|
| Rate for Payer: BCBS Transplant Transplant |
$2.75
|
| Rate for Payer: Blue Shield of California Commercial |
$2.89
|
| Rate for Payer: Blue Shield of California EPN |
$2.24
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$3.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.44
|
| Rate for Payer: IEHP medi-cal |
$1.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: Riverside University Health MISP |
$1.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.30
|
| Rate for Payer: United Healthcare All Other HMO |
$2.30
|
| Rate for Payer: United Healthcare HMO Rider |
$2.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3.90
|
|
|
HC YANKAUER FLEX W/FLANGE TIP STL
|
Facility
IP
|
$4.59
|
|
| Hospital Charge Code |
901698717
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
|
|
HC YANKAUER REG CAP FLANGE
|
Facility
OP
|
$4.43
|
|
| Hospital Charge Code |
901607937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.62
|
| Rate for Payer: BCBS Transplant Transplant |
$2.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2.79
|
| Rate for Payer: Blue Shield of California EPN |
$2.17
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: Cigna of CA HMO |
$2.84
|
| Rate for Payer: Cigna of CA PPO |
$3.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.99
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.32
|
| Rate for Payer: IEHP medi-cal |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.88
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.66
|
| Rate for Payer: Riverside University Health MISP |
$1.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.22
|
| Rate for Payer: United Healthcare All Other HMO |
$2.22
|
| Rate for Payer: United Healthcare HMO Rider |
$2.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.77
|
| Rate for Payer: Vantage Medical Group Senior |
$3.77
|
|
|
HC YANKAUER REG CAP FLANGE
|
Facility
IP
|
$4.43
|
|
| Hospital Charge Code |
901607937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.99 |
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.88
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
|
|
HC YANKAUER RIGID W/FLANGE TIP
|
Facility
OP
|
$4.51
|
|
|
Service Code
|
CPT A4628
|
| Hospital Charge Code |
901698698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$9.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.66
|
| Rate for Payer: BCBS Transplant Transplant |
$2.71
|
| Rate for Payer: Blue Shield of California Commercial |
$2.84
|
| Rate for Payer: Blue Shield of California EPN |
$2.21
|
| Rate for Payer: Cash Price |
$2.03
|
| Rate for Payer: Cash Price |
$2.03
|
| Rate for Payer: Central Health Plan Commercial |
$3.61
|
| Rate for Payer: Cigna of CA HMO |
$2.89
|
| Rate for Payer: Cigna of CA PPO |
$3.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.80
|
| Rate for Payer: Galaxy Health WC |
$3.83
|
| Rate for Payer: Global Benefits Group Commercial |
$2.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.06
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.38
|
| Rate for Payer: IEHP medi-cal |
$1.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.90
|
| Rate for Payer: Multiplan Commercial |
$3.38
|
| Rate for Payer: Networks By Design Commercial |
$2.93
|
| Rate for Payer: Prime Health Services Commercial |
$3.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.71
|
| Rate for Payer: Riverside University Health MISP |
$1.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.26
|
| Rate for Payer: United Healthcare All Other HMO |
$2.26
|
| Rate for Payer: United Healthcare HMO Rider |
$2.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.83
|
|
|
HC YANKAUER RIGID W/FLANGE TIP
|
Facility
IP
|
$4.51
|
|
|
Service Code
|
CPT A4628
|
| Hospital Charge Code |
901698698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$4.06 |
| Rate for Payer: Cash Price |
$2.03
|
| Rate for Payer: Central Health Plan Commercial |
$3.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.80
|
| Rate for Payer: Galaxy Health WC |
$3.83
|
| Rate for Payer: Global Benefits Group Commercial |
$2.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.90
|
| Rate for Payer: Multiplan Commercial |
$3.38
|
| Rate for Payer: Networks By Design Commercial |
$2.93
|
| Rate for Payer: Prime Health Services Commercial |
$3.83
|
|
|
HC YANKAUER RIGID W/OPEN TIP STL
|
Facility
IP
|
$4.35
|
|
| Hospital Charge Code |
901698716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
|
|
HC YANKAUER RIGID W/OPEN TIP STL
|
Facility
OP
|
$4.35
|
|
| Hospital Charge Code |
901698716
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.57
|
| Rate for Payer: BCBS Transplant Transplant |
$2.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2.74
|
| Rate for Payer: Blue Shield of California EPN |
$2.13
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$3.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.26
|
| Rate for Payer: IEHP medi-cal |
$1.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.61
|
| Rate for Payer: Riverside University Health MISP |
$1.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.18
|
| Rate for Payer: United Healthcare All Other HMO |
$2.18
|
| Rate for Payer: United Healthcare HMO Rider |
$2.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3.70
|
|
|
HC YANKAUER SUCTN FLEXI FINE CAP
|
Facility
OP
|
$4.43
|
|
| Hospital Charge Code |
901698615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.62
|
| Rate for Payer: BCBS Transplant Transplant |
$2.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2.79
|
| Rate for Payer: Blue Shield of California EPN |
$2.17
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: Cigna of CA HMO |
$2.84
|
| Rate for Payer: Cigna of CA PPO |
$3.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.99
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.32
|
| Rate for Payer: IEHP medi-cal |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.88
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.66
|
| Rate for Payer: Riverside University Health MISP |
$1.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.22
|
| Rate for Payer: United Healthcare All Other HMO |
$2.22
|
| Rate for Payer: United Healthcare HMO Rider |
$2.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.77
|
| Rate for Payer: Vantage Medical Group Senior |
$3.77
|
|
|
HC YANKAUER SUCTN FLEXI FINE CAP
|
Facility
IP
|
$4.43
|
|
| Hospital Charge Code |
901698615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.99 |
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.88
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
|
|
HC YANKAUER TIP ON/OFF CNTRL
|
Facility
OP
|
$9.92
|
|
| Hospital Charge Code |
901607946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.43
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.86
|
| Rate for Payer: BCBS Transplant Transplant |
$5.95
|
| Rate for Payer: Blue Shield of California Commercial |
$6.24
|
| Rate for Payer: Blue Shield of California EPN |
$4.85
|
| Rate for Payer: Cash Price |
$4.46
|
| Rate for Payer: Central Health Plan Commercial |
$7.94
|
| Rate for Payer: Cigna of CA HMO |
$6.35
|
| Rate for Payer: Cigna of CA PPO |
$7.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.97
|
| Rate for Payer: Galaxy Health WC |
$8.43
|
| Rate for Payer: Global Benefits Group Commercial |
$5.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.93
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.44
|
| Rate for Payer: IEHP medi-cal |
$3.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.98
|
| Rate for Payer: Multiplan Commercial |
$7.44
|
| Rate for Payer: Networks By Design Commercial |
$6.45
|
| Rate for Payer: Prime Health Services Commercial |
$8.43
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.95
|
| Rate for Payer: Riverside University Health MISP |
$3.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.96
|
| Rate for Payer: United Healthcare All Other HMO |
$4.96
|
| Rate for Payer: United Healthcare HMO Rider |
$4.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Vantage Medical Group Senior |
$8.43
|
|
|
HC YANKAUER TIP ON/OFF CNTRL
|
Facility
IP
|
$9.92
|
|
| Hospital Charge Code |
901607946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Cash Price |
$4.46
|
| Rate for Payer: Central Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.97
|
| Rate for Payer: Galaxy Health WC |
$8.43
|
| Rate for Payer: Global Benefits Group Commercial |
$5.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.98
|
| Rate for Payer: Multiplan Commercial |
$7.44
|
| Rate for Payer: Networks By Design Commercial |
$6.45
|
| Rate for Payer: Prime Health Services Commercial |
$8.43
|
|
|
HC YOKE TYPE ARM SUSPENSION SUPPO
|
Facility
IP
|
$1,553.00
|
|
|
Service Code
|
CPT L3969
|
| Hospital Charge Code |
903203969
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$310.60 |
| Max. Negotiated Rate |
$1,397.70 |
| Rate for Payer: Cash Price |
$698.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,242.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$621.20
|
| Rate for Payer: Galaxy Health WC |
$1,320.05
|
| Rate for Payer: Global Benefits Group Commercial |
$931.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,397.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,035.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.60
|
| Rate for Payer: Multiplan Commercial |
$1,164.75
|
| Rate for Payer: Networks By Design Commercial |
$1,009.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,320.05
|
|
|
HC YOKE TYPE ARM SUSPENSION SUPPO
|
Facility
OP
|
$1,553.00
|
|
|
Service Code
|
CPT L3969
|
| Hospital Charge Code |
903203969
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$310.60 |
| Max. Negotiated Rate |
$1,397.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$943.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,320.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$854.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$854.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$751.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$917.51
|
| Rate for Payer: BCBS Transplant Transplant |
$931.80
|
| Rate for Payer: Blue Shield of California Commercial |
$976.84
|
| Rate for Payer: Blue Shield of California EPN |
$759.42
|
| Rate for Payer: Cash Price |
$698.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,242.40
|
| Rate for Payer: Cigna of CA HMO |
$993.92
|
| Rate for Payer: Cigna of CA PPO |
$1,149.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,320.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$621.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$621.20
|
| Rate for Payer: Galaxy Health WC |
$1,320.05
|
| Rate for Payer: Global Benefits Group Commercial |
$931.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,397.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,164.75
|
| Rate for Payer: IEHP medi-cal |
$543.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,035.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.60
|
| Rate for Payer: Multiplan Commercial |
$1,164.75
|
| Rate for Payer: Networks By Design Commercial |
$1,009.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,320.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$931.80
|
| Rate for Payer: Riverside University Health MISP |
$621.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$931.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$931.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$776.50
|
| Rate for Payer: United Healthcare All Other HMO |
$776.50
|
| Rate for Payer: United Healthcare HMO Rider |
$776.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$776.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,320.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,320.05
|
|
|
HC Y STENT W POSTS AND 1MM WALL THCKNSS
|
Facility
OP
|
$2,214.00
|
|
| Hospital Charge Code |
900800913
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$442.80 |
| Max. Negotiated Rate |
$1,992.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,344.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,881.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,217.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,217.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,072.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,308.03
|
| Rate for Payer: BCBS Transplant Transplant |
$1,328.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,392.61
|
| Rate for Payer: Blue Shield of California EPN |
$1,082.65
|
| Rate for Payer: Cash Price |
$996.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,771.20
|
| Rate for Payer: Cigna of CA HMO |
$1,416.96
|
| Rate for Payer: Cigna of CA PPO |
$1,638.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,881.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$885.60
|
| Rate for Payer: Galaxy Health WC |
$1,881.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,328.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,992.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,660.50
|
| Rate for Payer: IEHP medi-cal |
$774.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,476.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.80
|
| Rate for Payer: Multiplan Commercial |
$1,660.50
|
| Rate for Payer: Networks By Design Commercial |
$1,439.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,881.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,328.40
|
| Rate for Payer: Riverside University Health MISP |
$885.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,328.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,328.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,107.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,107.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,107.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,107.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,881.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,881.90
|
|
|
HC Y STENT W POSTS AND 1MM WALL THCKNSS
|
Facility
IP
|
$2,214.00
|
|
| Hospital Charge Code |
900800913
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$442.80 |
| Max. Negotiated Rate |
$1,992.60 |
| Rate for Payer: Cash Price |
$996.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,771.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.60
|
| Rate for Payer: Galaxy Health WC |
$1,881.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,328.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,992.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,476.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.80
|
| Rate for Payer: Multiplan Commercial |
$1,660.50
|
| Rate for Payer: Networks By Design Commercial |
$1,439.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,881.90
|
|
|
HC ZELANTE CATHETER
|
Facility
OP
|
$8,798.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909001757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,759.60 |
| Max. Negotiated Rate |
$7,918.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,478.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,838.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,838.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,017.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,900.49
|
| Rate for Payer: BCBS Transplant Transplant |
$5,278.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,598.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,786.11
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,038.40
|
| Rate for Payer: Cigna of CA HMO |
$6,158.60
|
| Rate for Payer: Cigna of CA PPO |
$6,158.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,478.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,519.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,519.20
|
| Rate for Payer: Galaxy Health WC |
$7,478.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,918.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,598.50
|
| Rate for Payer: IEHP medi-cal |
$3,079.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,868.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.60
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: Networks By Design Commercial |
$4,399.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,478.30
|
| Rate for Payer: Riverside University Health MISP |
$3,519.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,278.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,278.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,399.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,399.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,399.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,399.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,478.30
|
| Rate for Payer: Vantage Medical Group Senior |
$7,478.30
|
|
|
HC ZELANTE CATHETER
|
Facility
IP
|
$8,798.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909001757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,759.60 |
| Max. Negotiated Rate |
$7,918.20 |
| Rate for Payer: Blue Shield of California EPN |
$4,698.13
|
| Rate for Payer: Cash Price |
$3,959.10
|
| Rate for Payer: Central Health Plan Commercial |
$7,038.40
|
| Rate for Payer: Cigna of CA HMO |
$6,158.60
|
| Rate for Payer: Cigna of CA PPO |
$6,158.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,519.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,519.20
|
| Rate for Payer: Galaxy Health WC |
$7,478.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,918.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,868.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.60
|
| Rate for Payer: Multiplan Commercial |
$6,598.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,478.30
|
|
|
HC ZEPHYR 4.0 DELIVERY CATHETER
|
Facility
OP
|
$2,300.00
|
|
| Hospital Charge Code |
900800952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,396.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,265.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,113.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,358.84
|
| Rate for Payer: BCBS Transplant Transplant |
$1,380.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,446.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,124.70
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,840.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,070.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,725.00
|
| Rate for Payer: IEHP medi-cal |
$805.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.00
|
| Rate for Payer: Multiplan Commercial |
$1,725.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: Riverside University Health MISP |
$920.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
