|
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: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 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: 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 |
$8.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.96
|
| Rate for Payer: Blue Distinction Transplant |
$9.10
|
| Rate for Payer: Blue Shield of California Commercial |
$9.54
|
| Rate for Payer: Blue Shield of California EPN |
$7.42
|
| Rate for Payer: Cash Price |
$6.83
|
| 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 Media |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$11.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.31
|
| 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: 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
|
| 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 Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
OP
|
$26.40
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.60
|
| Rate for Payer: Blue Distinction Transplant |
$15.84
|
| Rate for Payer: Blue Shield of California Commercial |
$16.61
|
| Rate for Payer: Blue Shield of California EPN |
$12.91
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: Cigna of CA HMO |
$16.90
|
| Rate for Payer: Cigna of CA PPO |
$19.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.44
|
| Rate for Payer: Dignity Health Media |
$22.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
| Rate for Payer: Riverside University Health System MISP |
$10.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
| Rate for Payer: United Healthcare All Other HMO |
$13.20
|
| Rate for Payer: United Healthcare HMO Rider |
$13.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.44
|
| Rate for Payer: Vantage Medical Group Senior |
$22.44
|
|
|
HC ARWY NASAL 14FR THIN WALL STERILE
|
Facility
|
IP
|
$26.40
|
|
| Hospital Charge Code |
901606461
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
OP
|
$26.49
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$23.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.65
|
| Rate for Payer: Blue Distinction Transplant |
$15.89
|
| Rate for Payer: Blue Shield of California Commercial |
$16.66
|
| Rate for Payer: Blue Shield of California EPN |
$12.95
|
| Rate for Payer: Cash Price |
$11.92
|
| Rate for Payer: Central Health Plan Commercial |
$21.19
|
| Rate for Payer: Cigna of CA HMO |
$16.95
|
| Rate for Payer: Cigna of CA PPO |
$19.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.52
|
| Rate for Payer: Dignity Health Media |
$22.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.60
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$19.87
|
| Rate for Payer: Networks By Design Commercial |
$17.22
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
| Rate for Payer: Riverside University Health System MISP |
$10.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.24
|
| Rate for Payer: United Healthcare All Other HMO |
$13.24
|
| Rate for Payer: United Healthcare HMO Rider |
$13.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.52
|
| Rate for Payer: Vantage Medical Group Senior |
$22.52
|
|
|
HC ARWY NASAL 16FR THIN WALL STERILE
|
Facility
|
IP
|
$26.49
|
|
| Hospital Charge Code |
901606462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$23.84 |
| Rate for Payer: Cash Price |
$11.92
|
| Rate for Payer: Central Health Plan Commercial |
$21.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$19.87
|
| Rate for Payer: Networks By Design Commercial |
$17.22
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
|
|
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: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 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: 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 |
$20.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.04
|
| Rate for Payer: Blue Distinction Transplant |
$22.39
|
| Rate for Payer: Blue Shield of California Commercial |
$23.47
|
| Rate for Payer: Blue Shield of California EPN |
$18.24
|
| Rate for Payer: Cash Price |
$16.79
|
| 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 Media |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$27.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.06
|
| 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: 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
|
| 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 Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
IP
|
$26.40
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
|
|
HC ARWY NASAL 18FR THIN WALL STERILE
|
Facility
|
OP
|
$26.40
|
|
| Hospital Charge Code |
901606463
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.60
|
| Rate for Payer: Blue Distinction Transplant |
$15.84
|
| Rate for Payer: Blue Shield of California Commercial |
$16.61
|
| Rate for Payer: Blue Shield of California EPN |
$12.91
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: Cigna of CA HMO |
$16.90
|
| Rate for Payer: Cigna of CA PPO |
$19.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.44
|
| Rate for Payer: Dignity Health Media |
$22.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
| Rate for Payer: Riverside University Health System MISP |
$10.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
| Rate for Payer: United Healthcare All Other HMO |
$13.20
|
| Rate for Payer: United Healthcare HMO Rider |
$13.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.44
|
| Rate for Payer: Vantage Medical Group Senior |
$22.44
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
OP
|
$15.17
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| 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 |
$8.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.96
|
| Rate for Payer: Blue Distinction Transplant |
$9.10
|
| Rate for Payer: Blue Shield of California Commercial |
$9.54
|
| Rate for Payer: Blue Shield of California EPN |
$7.42
|
| Rate for Payer: Cash Price |
$6.83
|
| 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 Media |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$11.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.31
|
| 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: 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
|
| 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 Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC ARWY NASAL 20FR THIN WALL STERILE
|
Facility
|
IP
|
$15.17
|
|
| Hospital Charge Code |
901606464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Central Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 26FR STERILE
|
Facility
|
IP
|
$24.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
|
|
HC ARWY NASAL 26FR STERILE
|
Facility
|
OP
|
$24.68
|
|
| Hospital Charge Code |
901606465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Distinction Transplant |
$14.81
|
| Rate for Payer: Blue Shield of California Commercial |
$15.52
|
| Rate for Payer: Blue Shield of California EPN |
$12.07
|
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: Cigna of CA HMO |
$15.80
|
| Rate for Payer: Cigna of CA PPO |
$18.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.98
|
| Rate for Payer: Dignity Health Media |
$20.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
| Rate for Payer: Riverside University Health System MISP |
$9.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.34
|
| Rate for Payer: United Healthcare All Other HMO |
$12.34
|
| Rate for Payer: United Healthcare HMO Rider |
$12.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.98
|
| Rate for Payer: Vantage Medical Group Senior |
$20.98
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
OP
|
$24.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Distinction Transplant |
$14.81
|
| Rate for Payer: Blue Shield of California Commercial |
$15.52
|
| Rate for Payer: Blue Shield of California EPN |
$12.07
|
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: Cigna of CA HMO |
$15.80
|
| Rate for Payer: Cigna of CA PPO |
$18.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.98
|
| Rate for Payer: Dignity Health Media |
$20.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
| Rate for Payer: Riverside University Health System MISP |
$9.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.34
|
| Rate for Payer: United Healthcare All Other HMO |
$12.34
|
| Rate for Payer: United Healthcare HMO Rider |
$12.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.98
|
| Rate for Payer: Vantage Medical Group Senior |
$20.98
|
|
|
HC ARWY NASAL 28FR STERILE
|
Facility
|
IP
|
$24.68
|
|
| Hospital Charge Code |
901606466
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
|
|
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: Cash Price |
$38.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$64.76
|
| 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: 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 |
$47.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.01
|
| Rate for Payer: Blue Distinction Transplant |
$51.80
|
| Rate for Payer: Blue Shield of California Commercial |
$54.31
|
| Rate for Payer: Blue Shield of California EPN |
$42.22
|
| Rate for Payer: Cash Price |
$38.85
|
| 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 Media |
$73.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$64.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.22
|
| 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: LLUH Dept of Risk Management WC |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$64.76
|
| 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 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: 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 |
$20.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.00
|
| Rate for Payer: Blue Distinction Transplant |
$22.34
|
| Rate for Payer: Blue Shield of California Commercial |
$23.42
|
| Rate for Payer: Blue Shield of California EPN |
$18.21
|
| Rate for Payer: Cash Price |
$16.75
|
| 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 Media |
$31.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$27.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.03
|
| 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: 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
|
| 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 |
$18.62
|
| Rate for Payer: United Healthcare All Other HMO |
$18.62
|
| Rate for Payer: United Healthcare HMO Rider |
$18.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.62
|
| 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: Cash Price |
$16.75
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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: 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 |
$20.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.04
|
| Rate for Payer: Blue Distinction Transplant |
$22.39
|
| Rate for Payer: Blue Shield of California Commercial |
$23.47
|
| Rate for Payer: Blue Shield of California EPN |
$18.24
|
| Rate for Payer: Cash Price |
$16.79
|
| 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 Media |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$27.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.06
|
| 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: 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
|
| 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 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: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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
|
IP
|
$24.68
|
|
| Hospital Charge Code |
901606467
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
|
|
HC ARWY NASAL 30FR STERILE
|
Facility
|
OP
|
$24.68
|
|
| Hospital Charge Code |
901606467
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Distinction Transplant |
$14.81
|
| Rate for Payer: Blue Shield of California Commercial |
$15.52
|
| Rate for Payer: Blue Shield of California EPN |
$12.07
|
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: Cigna of CA HMO |
$15.80
|
| Rate for Payer: Cigna of CA PPO |
$18.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.98
|
| Rate for Payer: Dignity Health Media |
$20.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
| Rate for Payer: Riverside University Health System MISP |
$9.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.34
|
| Rate for Payer: United Healthcare All Other HMO |
$12.34
|
| Rate for Payer: United Healthcare HMO Rider |
$12.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.98
|
| Rate for Payer: Vantage Medical Group Senior |
$20.98
|
|
|
HC ARWY NASAL 32FR STERILE
|
Facility
|
OP
|
$24.68
|
|
| Hospital Charge Code |
901606468
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Distinction Transplant |
$14.81
|
| Rate for Payer: Blue Shield of California Commercial |
$15.52
|
| Rate for Payer: Blue Shield of California EPN |
$12.07
|
| Rate for Payer: Cash Price |
$11.11
|
| Rate for Payer: Central Health Plan Commercial |
$19.74
|
| Rate for Payer: Cigna of CA HMO |
$15.80
|
| Rate for Payer: Cigna of CA PPO |
$18.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.98
|
| Rate for Payer: Dignity Health Media |
$20.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.87
|
| Rate for Payer: Galaxy Health WC |
$20.98
|
| Rate for Payer: Global Benefits Group Commercial |
$14.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.21
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$18.51
|
| Rate for Payer: Networks By Design Commercial |
$16.04
|
| Rate for Payer: Prime Health Services Commercial |
$20.98
|
| Rate for Payer: Riverside University Health System MISP |
$9.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.34
|
| Rate for Payer: United Healthcare All Other HMO |
$12.34
|
| Rate for Payer: United Healthcare HMO Rider |
$12.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.98
|
| Rate for Payer: Vantage Medical Group Senior |
$20.98
|
|
