|
HC ARWY NASAL 26FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.62
|
| Rate for Payer: Blue Shield of California Commercial |
$8.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: InnovAge PACE Commercial |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.62
|
| Rate for Payer: Blue Shield of California Commercial |
$8.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: InnovAge PACE Commercial |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
IP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$77.71 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Cash Price |
$47.49
|
| Rate for Payer: Central Health Plan Commercial |
$69.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$64.75
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
|
|
HC ARWY NASAL 30FR SOFT LF
|
Facility
|
OP
|
$86.34
|
|
| Hospital Charge Code |
901698476
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$77.71 |
| Rate for Payer: Adventist Health Commercial |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.71
|
| Rate for Payer: Blue Shield of California Commercial |
$52.75
|
| Rate for Payer: Blue Shield of California EPN |
$34.45
|
| Rate for Payer: Cash Price |
$47.49
|
| Rate for Payer: Central Health Plan Commercial |
$69.07
|
| Rate for Payer: Cigna of CA HMO |
$55.26
|
| Rate for Payer: Cigna of CA PPO |
$63.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Senior |
$34.54
|
| Rate for Payer: Galaxy Health WC |
$73.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.71
|
| Rate for Payer: InnovAge PACE Commercial |
$43.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.44
|
| Rate for Payer: Multiplan Commercial |
$64.75
|
| Rate for Payer: Networks By Design Commercial |
$56.12
|
| Rate for Payer: Prime Health Services Commercial |
$73.39
|
| Rate for Payer: Riverside University Health System MISP |
$34.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.17
|
| Rate for Payer: United Healthcare All Other HMO |
$43.17
|
| Rate for Payer: United Healthcare HMO Rider |
$43.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.39
|
| Rate for Payer: Vantage Medical Group Senior |
$73.39
|
|
|
HC ARWY NASAL 30FR SOFT PVC
|
Facility
|
OP
|
$37.23
|
|
| Hospital Charge Code |
901698475
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$33.51 |
| Rate for Payer: Adventist Health Commercial |
$7.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.87
|
| Rate for Payer: Blue Shield of California Commercial |
$22.75
|
| Rate for Payer: Blue Shield of California EPN |
$14.85
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: Cigna of CA HMO |
$23.83
|
| Rate for Payer: Cigna of CA PPO |
$27.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: InnovAge PACE Commercial |
$18.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.06
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
| Rate for Payer: Riverside University Health System MISP |
$14.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.61
|
| Rate for Payer: United Healthcare All Other HMO |
$18.61
|
| Rate for Payer: United Healthcare HMO Rider |
$18.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.65
|
| Rate for Payer: Vantage Medical Group Senior |
$31.65
|
|
|
HC ARWY NASAL 30FR SOFT PVC
|
Facility
|
IP
|
$37.23
|
|
| Hospital Charge Code |
901698475
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$33.51 |
| Rate for Payer: Adventist Health Commercial |
$7.45
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
|
|
HC ARWY NASAL 30FR SOFT STRL
|
Facility
|
OP
|
$37.31
|
|
| Hospital Charge Code |
901698477
|
|
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 30FR SOFT STRL
|
Facility
|
IP
|
$37.31
|
|
| Hospital Charge Code |
901698477
|
|
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 30FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606467
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.62
|
| Rate for Payer: Blue Shield of California Commercial |
$8.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: InnovAge PACE Commercial |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 30FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606467
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 32FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606468
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 32FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606468
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.62
|
| Rate for Payer: Blue Shield of California Commercial |
$8.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: InnovAge PACE Commercial |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY NASAL 32FR STRL
|
Facility
|
IP
|
$35.92
|
|
| Hospital Charge Code |
901698720
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
|
|
HC ARWY NASAL 32FR STRL
|
Facility
|
OP
|
$35.92
|
|
| Hospital Charge Code |
901698720
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$32.33 |
| Rate for Payer: Adventist Health Commercial |
$7.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.10
|
| Rate for Payer: Blue Shield of California Commercial |
$21.95
|
| Rate for Payer: Blue Shield of California EPN |
$14.33
|
| Rate for Payer: Cash Price |
$19.76
|
| Rate for Payer: Central Health Plan Commercial |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$22.99
|
| Rate for Payer: Cigna of CA PPO |
$26.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.37
|
| Rate for Payer: Galaxy Health WC |
$30.53
|
| Rate for Payer: Global Benefits Group Commercial |
$21.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.33
|
| Rate for Payer: InnovAge PACE Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.14
|
| Rate for Payer: Multiplan Commercial |
$26.94
|
| Rate for Payer: Networks By Design Commercial |
$23.35
|
| Rate for Payer: Prime Health Services Commercial |
$30.53
|
| Rate for Payer: Riverside University Health System MISP |
$14.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.53
|
| Rate for Payer: Vantage Medical Group Senior |
$30.53
|
|
|
HC ARWY NASAL 34FR STERILE
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901606469
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC ARWY NASAL 34FR STERILE
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901606469
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$13.21 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.62
|
| Rate for Payer: Blue Shield of California Commercial |
$8.97
|
| Rate for Payer: Blue Shield of California EPN |
$5.86
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.74
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.21
|
| Rate for Payer: InnovAge PACE Commercial |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.01
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Riverside University Health System MISP |
$5.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC ARWY ORAL ADULT SZ 4 LMA
|
Facility
|
OP
|
$49.69
|
|
| Hospital Charge Code |
901604974
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.18
|
| Rate for Payer: Blue Shield of California Commercial |
$30.36
|
| Rate for Payer: Blue Shield of California EPN |
$19.83
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: Cigna of CA HMO |
$31.80
|
| Rate for Payer: Cigna of CA PPO |
$36.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: InnovAge PACE Commercial |
$24.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.78
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
| Rate for Payer: Riverside University Health System MISP |
$19.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.84
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.24
|
| Rate for Payer: Vantage Medical Group Senior |
$42.24
|
|
|
HC ARWY ORAL ADULT SZ 4 LMA
|
Facility
|
IP
|
$49.69
|
|
| Hospital Charge Code |
901604974
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
|
|
HC ARWY ORAL ADULT SZ 5 LMA
|
Facility
|
IP
|
$49.69
|
|
| Hospital Charge Code |
901604975
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
|
|
HC ARWY ORAL ADULT SZ 5 LMA
|
Facility
|
OP
|
$49.69
|
|
| Hospital Charge Code |
901604975
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.18
|
| Rate for Payer: Blue Shield of California Commercial |
$30.36
|
| Rate for Payer: Blue Shield of California EPN |
$19.83
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: Cigna of CA HMO |
$31.80
|
| Rate for Payer: Cigna of CA PPO |
$36.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: InnovAge PACE Commercial |
$24.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.78
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
| Rate for Payer: Riverside University Health System MISP |
$19.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.84
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.24
|
| Rate for Payer: Vantage Medical Group Senior |
$42.24
|
|
|
HC ARWY ORAL CHILD SZ 2.5 LMA
|
Facility
|
IP
|
$49.69
|
|
| Hospital Charge Code |
901604972
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
|
|
HC ARWY ORAL CHILD SZ 2.5 LMA
|
Facility
|
OP
|
$49.69
|
|
| Hospital Charge Code |
901604972
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.18
|
| Rate for Payer: Blue Shield of California Commercial |
$30.36
|
| Rate for Payer: Blue Shield of California EPN |
$19.83
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: Cigna of CA HMO |
$31.80
|
| Rate for Payer: Cigna of CA PPO |
$36.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: InnovAge PACE Commercial |
$24.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.78
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
| Rate for Payer: Riverside University Health System MISP |
$19.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.84
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.24
|
| Rate for Payer: Vantage Medical Group Senior |
$42.24
|
|
|
HC ARWY ORAL CHILD SZ 3 LMA
|
Facility
|
IP
|
$49.69
|
|
| Hospital Charge Code |
901604973
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$44.72 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Cash Price |
$27.33
|
| Rate for Payer: Central Health Plan Commercial |
$39.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.94
|
| Rate for Payer: Multiplan Commercial |
$37.27
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
|
