|
HC ARTHROGRAPH KNEE
|
Facility
|
IP
|
$2,189.00
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
909001658
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$437.80 |
| Max. Negotiated Rate |
$1,970.10 |
| Rate for Payer: Adventist Health Commercial |
$437.80
|
| Rate for Payer: Cash Price |
$1,203.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,751.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$875.60
|
| Rate for Payer: EPIC Health Plan Senior |
$875.60
|
| Rate for Payer: Galaxy Health WC |
$1,860.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,313.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,970.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,460.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$834.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,354.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$437.80
|
| Rate for Payer: Multiplan Commercial |
$1,641.75
|
| Rate for Payer: Networks By Design Commercial |
$1,422.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,860.65
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
IP
|
$2,837.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$567.40 |
| Max. Negotiated Rate |
$2,553.30 |
| Rate for Payer: Adventist Health Commercial |
$567.40
|
| Rate for Payer: Cash Price |
$1,560.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,269.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,134.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,134.80
|
| Rate for Payer: Galaxy Health WC |
$2,411.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,702.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,553.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,892.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,080.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,756.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.40
|
| Rate for Payer: Multiplan Commercial |
$2,127.75
|
| Rate for Payer: Networks By Design Commercial |
$1,844.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,411.45
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
OP
|
$2,837.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$87.19 |
| Max. Negotiated Rate |
$2,553.30 |
| Rate for Payer: Adventist Health Commercial |
$567.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,722.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,722.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,126.29
|
| Rate for Payer: Cash Price |
$1,560.35
|
| Rate for Payer: Cash Price |
$1,560.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,269.60
|
| Rate for Payer: Cigna of CA HMO |
$1,815.68
|
| Rate for Payer: Cigna of CA PPO |
$2,099.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,411.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,702.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,553.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,892.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,127.75
|
| Rate for Payer: Networks By Design Commercial |
$1,844.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,411.45
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,702.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,702.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
IP
|
$2,382.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$476.40 |
| Max. Negotiated Rate |
$2,143.80 |
| Rate for Payer: Adventist Health Commercial |
$476.40
|
| Rate for Payer: Cash Price |
$1,310.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,905.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$952.80
|
| Rate for Payer: EPIC Health Plan Senior |
$952.80
|
| Rate for Payer: Galaxy Health WC |
$2,024.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,143.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,588.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.40
|
| Rate for Payer: Multiplan Commercial |
$1,786.50
|
| Rate for Payer: Networks By Design Commercial |
$1,548.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,024.70
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
OP
|
$2,382.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$66.34 |
| Max. Negotiated Rate |
$2,143.80 |
| Rate for Payer: Adventist Health Commercial |
$476.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,446.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$326.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1,445.87
|
| Rate for Payer: Blue Shield of California EPN |
$945.65
|
| Rate for Payer: Cash Price |
$1,310.10
|
| Rate for Payer: Cash Price |
$1,310.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,905.60
|
| Rate for Payer: Cigna of CA HMO |
$1,524.48
|
| Rate for Payer: Cigna of CA PPO |
$1,762.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,024.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,143.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,588.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$1,786.50
|
| Rate for Payer: Networks By Design Commercial |
$1,548.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,024.70
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,429.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC ARTHROSCOPY KNEE DIAG W OR WO BX
|
Facility
|
IP
|
$10,307.00
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
906601870
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,061.40 |
| Max. Negotiated Rate |
$9,276.30 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Cash Price |
$5,668.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,122.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.80
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,874.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,926.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,380.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
|
|
HC ARTHROSCOPY KNEE DIAG W OR WO BX
|
Facility
|
OP
|
$10,307.00
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
906601870
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$478.99 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,122.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,668.85
|
| Rate for Payer: Cash Price |
$5,668.85
|
| Rate for Payer: Cash Price |
$5,668.85
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: Cigna of CA HMO |
$6,596.48
|
| Rate for Payer: Cigna of CA PPO |
$7,627.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,874.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$529.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,184.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
OP
|
$16,045.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$14,440.50 |
| Rate for Payer: Adventist Health Commercial |
$3,209.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$8,824.75
|
| Rate for Payer: Cash Price |
$8,824.75
|
| Rate for Payer: Cash Price |
$8,824.75
|
| Rate for Payer: Cash Price |
$8,824.75
|
| Rate for Payer: Central Health Plan Commercial |
$12,836.00
|
| Rate for Payer: Cigna of CA HMO |
$10,268.80
|
| Rate for Payer: Cigna of CA PPO |
$11,873.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$13,638.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,627.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,440.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,702.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,209.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$12,033.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,429.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$13,638.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,627.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,022.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,022.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,022.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,022.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
IP
|
$16,045.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,209.00 |
| Max. Negotiated Rate |
$14,440.50 |
| Rate for Payer: Adventist Health Commercial |
$3,209.00
|
| Rate for Payer: Cash Price |
$8,824.75
|
| Rate for Payer: Central Health Plan Commercial |
$12,836.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,418.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,418.00
|
| Rate for Payer: Galaxy Health WC |
$13,638.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,627.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,440.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,702.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,113.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,931.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,209.00
|
| Rate for Payer: Multiplan Commercial |
$12,033.75
|
| Rate for Payer: Networks By Design Commercial |
$10,429.25
|
| Rate for Payer: Prime Health Services Commercial |
$13,638.25
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
IP
|
$12,333.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,466.60 |
| Max. Negotiated Rate |
$11,099.70 |
| Rate for Payer: Adventist Health Commercial |
$2,466.60
|
| Rate for Payer: Cash Price |
$6,783.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,866.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,933.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,933.20
|
| Rate for Payer: Galaxy Health WC |
$10,483.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,399.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,099.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,698.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,634.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.60
|
| Rate for Payer: Multiplan Commercial |
$9,249.75
|
| Rate for Payer: Networks By Design Commercial |
$8,016.45
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.05
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
OP
|
$12,333.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$11,099.70 |
| Rate for Payer: Adventist Health Commercial |
$5,056.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$6,783.15
|
| Rate for Payer: Cash Price |
$6,783.15
|
| Rate for Payer: Cash Price |
$6,783.15
|
| Rate for Payer: Cash Price |
$6,783.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,866.40
|
| Rate for Payer: Cigna of CA HMO |
$7,893.12
|
| Rate for Payer: Cigna of CA PPO |
$9,126.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$10,483.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,399.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,099.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$9,249.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,016.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,399.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,399.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
IP
|
$47.56
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
OP
|
$47.56
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$42.80 |
| Rate for Payer: Adventist Health Commercial |
$9.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.93
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.98
|
| Rate for Payer: Cash Price |
$26.16
|
| Rate for Payer: Central Health Plan Commercial |
$38.05
|
| Rate for Payer: Cigna of CA HMO |
$30.44
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$19.02
|
| Rate for Payer: Galaxy Health WC |
$40.43
|
| Rate for Payer: Global Benefits Group Commercial |
$28.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.80
|
| Rate for Payer: InnovAge PACE Commercial |
$23.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.29
|
| Rate for Payer: Multiplan Commercial |
$35.67
|
| Rate for Payer: Networks By Design Commercial |
$30.91
|
| Rate for Payer: Prime Health Services Commercial |
$40.43
|
| Rate for Payer: Riverside University Health System MISP |
$19.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.43
|
| Rate for Payer: Vantage Medical Group Senior |
$40.43
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
OP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.91
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: Cigna of CA HMO |
$9.71
|
| Rate for Payer: Cigna of CA PPO |
$11.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: InnovAge PACE Commercial |
$7.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.62
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
| Rate for Payer: Riverside University Health System MISP |
$6.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC ARWY NASAL 12FR THIN WALL STERILE
|
Facility
|
IP
|
$15.17
|
|
| Hospital Charge Code |
901606460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.03
|
| Rate for Payer: Multiplan Commercial |
$11.38
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.37
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: InnovAge PACE Commercial |
$7.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.37
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: InnovAge PACE Commercial |
$7.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
OP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.91
|
| Rate for Payer: Blue Shield of California Commercial |
$22.80
|
| Rate for Payer: Blue Shield of California EPN |
$14.89
|
| Rate for Payer: Cash Price |
$20.52
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: Cigna of CA HMO |
$23.88
|
| Rate for Payer: Cigna of CA PPO |
$27.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: InnovAge PACE Commercial |
$18.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Riverside University Health System MISP |
$14.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.66
|
| Rate for Payer: United Healthcare All Other HMO |
$18.66
|
| Rate for Payer: United Healthcare HMO Rider |
$18.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC ARWY NASAL 18FR ADJ FLNGE SFT
|
Facility
|
IP
|
$37.31
|
|
| Hospital Charge Code |
901698391
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Cash Price |
$20.52
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.46
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
IP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
OP
|
$15.33
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.37
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.43
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: Cigna of CA HMO |
$9.81
|
| Rate for Payer: Cigna of CA PPO |
$11.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: EPIC Health Plan Senior |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: InnovAge PACE Commercial |
$7.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.73
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.67
|
| Rate for Payer: United Healthcare All Other HMO |
$7.67
|
| Rate for Payer: United Healthcare HMO Rider |
$7.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.03
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.19
|
| Rate for Payer: Blue Shield of California Commercial |
$8.52
|
| Rate for Payer: Blue Shield of California EPN |
$5.56
|
| Rate for Payer: Cash Price |
$7.67
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Cigna of CA HMO |
$8.92
|
| Rate for Payer: Cigna of CA PPO |
$10.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: InnovAge PACE Commercial |
$6.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.76
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
| Rate for Payer: Riverside University Health System MISP |
$5.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.97
|
| Rate for Payer: United Healthcare All Other HMO |
$6.97
|
| Rate for Payer: United Healthcare HMO Rider |
$6.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$7.67
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
