|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$312.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$202.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$220.80
|
| Rate for Payer: Blue Shield of California Commercial |
$231.47
|
| Rate for Payer: Blue Shield of California EPN |
$179.95
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Central Health Plan Commercial |
$294.40
|
| Rate for Payer: Cigna of CA HMO |
$235.52
|
| Rate for Payer: Cigna of CA PPO |
$272.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$312.80
|
| Rate for Payer: Dignity Health Media |
$312.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$312.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$147.20
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$331.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$276.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.60
|
| Rate for Payer: Multiplan Commercial |
$276.00
|
| Rate for Payer: Networks By Design Commercial |
$239.20
|
| Rate for Payer: Prime Health Services Commercial |
$312.80
|
| Rate for Payer: Riverside University Health System MISP |
$147.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$184.00
|
| Rate for Payer: United Healthcare All Other HMO |
$184.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$184.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$312.80
|
| Rate for Payer: Vantage Medical Group Senior |
$312.80
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Central Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.20
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$331.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.60
|
| Rate for Payer: Multiplan Commercial |
$276.00
|
| Rate for Payer: Networks By Design Commercial |
$239.20
|
| Rate for Payer: Prime Health Services Commercial |
$312.80
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Central Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.20
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$331.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.60
|
| Rate for Payer: Multiplan Commercial |
$276.00
|
| Rate for Payer: Networks By Design Commercial |
$239.20
|
| Rate for Payer: Prime Health Services Commercial |
$312.80
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$312.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$202.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$220.80
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Central Health Plan Commercial |
$294.40
|
| Rate for Payer: Cigna of CA PPO |
$272.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$312.80
|
| Rate for Payer: Dignity Health Media |
$312.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$312.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$147.20
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$331.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$276.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.60
|
| Rate for Payer: Multiplan Commercial |
$276.00
|
| Rate for Payer: Networks By Design Commercial |
$239.20
|
| Rate for Payer: Prime Health Services Commercial |
$312.80
|
| Rate for Payer: Riverside University Health System MISP |
$147.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$184.00
|
| Rate for Payer: United Healthcare All Other HMO |
$184.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$184.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$312.80
|
| Rate for Payer: Vantage Medical Group Senior |
$312.80
|
|
|
HC AVX ANGIOJET, CATH
|
Facility
|
IP
|
$1,620.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909080036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Blue Shield of California EPN |
$865.08
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,080.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$611.71
|
| Rate for Payer: United Healthcare All Other HMO |
$597.46
|
| Rate for Payer: United Healthcare HMO Rider |
$584.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$534.60
|
|
|
HC AVX ANGIOJET, CATH
|
Facility
|
OP
|
$1,620.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909080036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$891.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$891.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$739.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$902.34
|
| Rate for Payer: Blue Distinction Transplant |
$972.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,215.00
|
| Rate for Payer: Blue Shield of California EPN |
$881.28
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Dignity Health Media |
$1,377.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,377.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,215.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,080.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$617.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: Networks By Design Commercial |
$810.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: Riverside University Health System MISP |
$648.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$972.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$972.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$810.00
|
| Rate for Payer: United Healthcare All Other HMO |
$810.00
|
| Rate for Payer: United Healthcare HMO Rider |
$810.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$810.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,377.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
905350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Blue Shield of California EPN |
$213.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$151.04
|
| Rate for Payer: United Healthcare All Other HMO |
$147.52
|
| Rate for Payer: United Healthcare HMO Rider |
$144.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
905350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$220.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$193.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.32
|
| Rate for Payer: Blue Distinction Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$300.00
|
| Rate for Payer: Blue Shield of California EPN |
$217.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Media |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$300.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Riverside University Health System MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$200.00
|
| Rate for Payer: United Healthcare All Other HMO |
$200.00
|
| Rate for Payer: United Healthcare HMO Rider |
$200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC AZUR HYRDOCOIL
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Media |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,925.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC AZUR HYRDOCOIL
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC B ABORTUS AB
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911585
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC B ABORTUS AB
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911585
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$55.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.92
|
| Rate for Payer: Blue Distinction Transplant |
$7.80
|
| Rate for Payer: Blue Shield of California Commercial |
$8.03
|
| Rate for Payer: Blue Shield of California EPN |
$6.32
|
| Rate for Payer: Caremore Medicare Advantage |
$6.98
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Central Health Plan Commercial |
$10.40
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$9.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.47
|
| Rate for Payer: Dignity Health Media |
$6.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.98
|
| Rate for Payer: Galaxy Health WC |
$11.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.98
|
| Rate for Payer: InnovAge PACE Commercial |
$10.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.35
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: Networks By Design Commercial |
$8.45
|
| Rate for Payer: Prime Health Services Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Medicare |
$7.40
|
| Rate for Payer: Riverside University Health System MISP |
$7.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.65
|
| Rate for Payer: United Healthcare All Other HMO |
$5.65
|
| Rate for Payer: United Healthcare HMO Rider |
$5.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6.98
|
|
|
HC BACTERIAL ANTIGEN
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
900912496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
|
|
HC BACTERIAL ANTIGEN
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
900912496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$87.82 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.82
|
| Rate for Payer: Blue Distinction Transplant |
$50.40
|
| Rate for Payer: Blue Shield of California Commercial |
$51.91
|
| Rate for Payer: Blue Shield of California EPN |
$40.82
|
| Rate for Payer: Caremore Medicare Advantage |
$11.54
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.31
|
| Rate for Payer: Dignity Health Media |
$11.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.54
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.54
|
| Rate for Payer: InnovAge PACE Commercial |
$17.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.46
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$12.23
|
| Rate for Payer: Riverside University Health System MISP |
$12.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.35
|
| Rate for Payer: United Healthcare All Other HMO |
$9.35
|
| Rate for Payer: United Healthcare HMO Rider |
$9.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Vantage Medical Group Senior |
$11.54
|
|
|
HC BAG ACCUDRAIN CSF 700ML
|
Facility
|
OP
|
$260.89
|
|
| Hospital Charge Code |
901605661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.18 |
| Max. Negotiated Rate |
$234.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$158.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$126.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.13
|
| Rate for Payer: Blue Distinction Transplant |
$156.53
|
| Rate for Payer: Blue Shield of California Commercial |
$164.10
|
| Rate for Payer: Blue Shield of California EPN |
$127.58
|
| Rate for Payer: Cash Price |
$117.40
|
| Rate for Payer: Central Health Plan Commercial |
$208.71
|
| Rate for Payer: Cigna of CA HMO |
$166.97
|
| Rate for Payer: Cigna of CA PPO |
$193.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.76
|
| Rate for Payer: Dignity Health Media |
$221.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$221.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$104.36
|
| Rate for Payer: Galaxy Health WC |
$221.76
|
| Rate for Payer: Global Benefits Group Commercial |
$156.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$195.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.18
|
| Rate for Payer: Multiplan Commercial |
$195.67
|
| Rate for Payer: Networks By Design Commercial |
$169.58
|
| Rate for Payer: Prime Health Services Commercial |
$221.76
|
| Rate for Payer: Riverside University Health System MISP |
$104.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$130.44
|
| Rate for Payer: United Healthcare All Other HMO |
$130.44
|
| Rate for Payer: United Healthcare HMO Rider |
$130.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$130.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$221.76
|
| Rate for Payer: Vantage Medical Group Senior |
$221.76
|
|
|
HC BAG ACCUDRAIN CSF 700ML
|
Facility
|
IP
|
$260.89
|
|
| Hospital Charge Code |
901605661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.18 |
| Max. Negotiated Rate |
$234.80 |
| Rate for Payer: Cash Price |
$117.40
|
| Rate for Payer: Central Health Plan Commercial |
$208.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.36
|
| Rate for Payer: Galaxy Health WC |
$221.76
|
| Rate for Payer: Global Benefits Group Commercial |
$156.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.18
|
| Rate for Payer: Multiplan Commercial |
$195.67
|
| Rate for Payer: Networks By Design Commercial |
$169.58
|
| Rate for Payer: Prime Health Services Commercial |
$221.76
|
|
|
HC BAG BILE DISP
|
Facility
|
OP
|
$42.48
|
|
| Hospital Charge Code |
901600101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$38.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.10
|
| Rate for Payer: Blue Distinction Transplant |
$25.49
|
| Rate for Payer: Blue Shield of California Commercial |
$26.72
|
| Rate for Payer: Blue Shield of California EPN |
$20.77
|
| Rate for Payer: Cash Price |
$19.12
|
| Rate for Payer: Central Health Plan Commercial |
$33.98
|
| Rate for Payer: Cigna of CA HMO |
$27.19
|
| Rate for Payer: Cigna of CA PPO |
$31.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.11
|
| Rate for Payer: Dignity Health Media |
$36.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.99
|
| Rate for Payer: Galaxy Health WC |
$36.11
|
| Rate for Payer: Global Benefits Group Commercial |
$25.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.23
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$31.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$31.86
|
| Rate for Payer: Networks By Design Commercial |
$27.61
|
| Rate for Payer: Prime Health Services Commercial |
$36.11
|
| Rate for Payer: Riverside University Health System MISP |
$16.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.24
|
| Rate for Payer: United Healthcare All Other HMO |
$21.24
|
| Rate for Payer: United Healthcare HMO Rider |
$21.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.11
|
| Rate for Payer: Vantage Medical Group Senior |
$36.11
|
|
|
HC BAG BILE DISP
|
Facility
|
IP
|
$42.48
|
|
| Hospital Charge Code |
901600101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$38.23 |
| Rate for Payer: Cash Price |
$19.12
|
| Rate for Payer: Central Health Plan Commercial |
$33.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.99
|
| Rate for Payer: Galaxy Health WC |
$36.11
|
| Rate for Payer: Global Benefits Group Commercial |
$25.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.50
|
| Rate for Payer: Multiplan Commercial |
$31.86
|
| Rate for Payer: Networks By Design Commercial |
$27.61
|
| Rate for Payer: Prime Health Services Commercial |
$36.11
|
|
|
HC BAG BILE DRAINAGE
|
Facility
|
OP
|
$10.60
|
|
| Hospital Charge Code |
909001075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.26
|
| Rate for Payer: Blue Distinction Transplant |
$6.36
|
| Rate for Payer: Blue Shield of California Commercial |
$6.67
|
| Rate for Payer: Blue Shield of California EPN |
$5.18
|
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Central Health Plan Commercial |
$8.48
|
| Rate for Payer: Cigna of CA HMO |
$6.78
|
| Rate for Payer: Cigna of CA PPO |
$7.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.01
|
| Rate for Payer: Dignity Health Media |
$9.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$9.01
|
| Rate for Payer: Global Benefits Group Commercial |
$6.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.54
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.95
|
| Rate for Payer: Networks By Design Commercial |
$6.89
|
| Rate for Payer: Prime Health Services Commercial |
$9.01
|
| Rate for Payer: Riverside University Health System MISP |
$4.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.30
|
| Rate for Payer: United Healthcare All Other HMO |
$5.30
|
| Rate for Payer: United Healthcare HMO Rider |
$5.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$9.01
|
|
|
HC BAG BILE DRAINAGE
|
Facility
|
IP
|
$10.60
|
|
| Hospital Charge Code |
909001075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.54 |
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Central Health Plan Commercial |
$8.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$9.01
|
| Rate for Payer: Global Benefits Group Commercial |
$6.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.95
|
| Rate for Payer: Networks By Design Commercial |
$6.89
|
| Rate for Payer: Prime Health Services Commercial |
$9.01
|
|
|
HC BAG DRAINAGE 4L A/R TWR LL
|
Facility
|
OP
|
$24.52
|
|
| Hospital Charge Code |
901607520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.49
|
| Rate for Payer: Blue Distinction Transplant |
$14.71
|
| Rate for Payer: Blue Shield of California Commercial |
$15.42
|
| Rate for Payer: Blue Shield of California EPN |
$11.99
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Central Health Plan Commercial |
$19.62
|
| Rate for Payer: Cigna of CA HMO |
$15.69
|
| Rate for Payer: Cigna of CA PPO |
$18.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.84
|
| Rate for Payer: Dignity Health Media |
$20.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: Multiplan Commercial |
$18.39
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
| Rate for Payer: Riverside University Health System MISP |
$9.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.26
|
| Rate for Payer: United Healthcare All Other HMO |
$12.26
|
| Rate for Payer: United Healthcare HMO Rider |
$12.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.84
|
| Rate for Payer: Vantage Medical Group Senior |
$20.84
|
|
|
HC BAG DRAINAGE 4L A/R TWR LL
|
Facility
|
IP
|
$24.52
|
|
| Hospital Charge Code |
901607520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Central Health Plan Commercial |
$19.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: Multiplan Commercial |
$18.39
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
|
|
HC BAG DRAINAGE URESIL GRAVITY
|
Facility
|
IP
|
$69.00
|
|
| Hospital Charge Code |
909001098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Central Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.60
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.80
|
| Rate for Payer: Multiplan Commercial |
$51.75
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
|
|
HC BAG DRAINAGE URESIL GRAVITY
|
Facility
|
OP
|
$69.00
|
|
| Hospital Charge Code |
909001098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.77
|
| Rate for Payer: Blue Distinction Transplant |
$41.40
|
| Rate for Payer: Blue Shield of California Commercial |
$43.40
|
| Rate for Payer: Blue Shield of California EPN |
$33.74
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Central Health Plan Commercial |
$55.20
|
| Rate for Payer: Cigna of CA HMO |
$44.16
|
| Rate for Payer: Cigna of CA PPO |
$51.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.65
|
| Rate for Payer: Dignity Health Media |
$58.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$58.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$27.60
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$51.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.80
|
| Rate for Payer: Multiplan Commercial |
$51.75
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
| Rate for Payer: Riverside University Health System MISP |
$27.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.50
|
| Rate for Payer: United Healthcare All Other HMO |
$34.50
|
| Rate for Payer: United Healthcare HMO Rider |
$34.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$58.65
|
| Rate for Payer: Vantage Medical Group Senior |
$58.65
|
|
|
HC BAG DRAINAGE URESIL SUCTION
|
Facility
|
IP
|
$88.00
|
|
| Hospital Charge Code |
909002002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
