|
HC BAG DRAINAGE URESIL SUCTION
|
Facility
OP
|
$88.00
|
|
| Hospital Charge Code |
909002002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$74.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$48.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$48.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.99
|
| Rate for Payer: BCBS Transplant Transplant |
$52.80
|
| Rate for Payer: Blue Shield of California Commercial |
$55.35
|
| Rate for Payer: Blue Shield of California EPN |
$43.03
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$74.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$66.00
|
| Rate for Payer: IEHP medi-cal |
$30.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: Riverside University Health MISP |
$35.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44.00
|
| Rate for Payer: United Healthcare HMO Rider |
$44.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.80
|
| Rate for Payer: Vantage Medical Group Senior |
$74.80
|
|
|
HC BAG DRAIN ANTI REFLX L/F 2000ML
|
Facility
OP
|
$18.53
|
|
| Hospital Charge Code |
901607521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$16.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.95
|
| Rate for Payer: BCBS Transplant Transplant |
$11.12
|
| Rate for Payer: Blue Shield of California Commercial |
$11.66
|
| Rate for Payer: Blue Shield of California EPN |
$9.06
|
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Central Health Plan Commercial |
$14.82
|
| Rate for Payer: Cigna of CA HMO |
$11.86
|
| Rate for Payer: Cigna of CA PPO |
$13.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.41
|
| Rate for Payer: Galaxy Health WC |
$15.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.90
|
| Rate for Payer: IEHP medi-cal |
$6.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.71
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
| Rate for Payer: Networks By Design Commercial |
$12.04
|
| Rate for Payer: Prime Health Services Commercial |
$15.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.12
|
| Rate for Payer: Riverside University Health MISP |
$7.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.26
|
| Rate for Payer: United Healthcare All Other HMO |
$9.26
|
| Rate for Payer: United Healthcare HMO Rider |
$9.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.75
|
| Rate for Payer: Vantage Medical Group Senior |
$15.75
|
|
|
HC BAG DRAIN ANTI REFLX L/F 2000ML
|
Facility
IP
|
$18.53
|
|
| Hospital Charge Code |
901607521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$16.68 |
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Central Health Plan Commercial |
$14.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.41
|
| Rate for Payer: Galaxy Health WC |
$15.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.71
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
| Rate for Payer: Networks By Design Commercial |
$12.04
|
| Rate for Payer: Prime Health Services Commercial |
$15.75
|
|
|
HC BAG DRAIN INTEFRA LIMITORR
|
Facility
OP
|
$262.99
|
|
| Hospital Charge Code |
901605691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$236.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$159.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$223.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$144.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$144.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$127.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.37
|
| Rate for Payer: BCBS Transplant Transplant |
$157.79
|
| Rate for Payer: Blue Shield of California Commercial |
$165.42
|
| Rate for Payer: Blue Shield of California EPN |
$128.60
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Central Health Plan Commercial |
$210.39
|
| Rate for Payer: Cigna of CA HMO |
$168.31
|
| Rate for Payer: Cigna of CA PPO |
$194.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$223.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$105.20
|
| Rate for Payer: Galaxy Health WC |
$223.54
|
| Rate for Payer: Global Benefits Group Commercial |
$157.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$236.69
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$197.24
|
| Rate for Payer: IEHP medi-cal |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$175.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.60
|
| Rate for Payer: Multiplan Commercial |
$197.24
|
| Rate for Payer: Networks By Design Commercial |
$170.94
|
| Rate for Payer: Prime Health Services Commercial |
$223.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$157.79
|
| Rate for Payer: Riverside University Health MISP |
$105.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.50
|
| Rate for Payer: United Healthcare All Other HMO |
$131.50
|
| Rate for Payer: United Healthcare HMO Rider |
$131.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$223.54
|
| Rate for Payer: Vantage Medical Group Senior |
$223.54
|
|
|
HC BAG DRAIN INTEFRA LIMITORR
|
Facility
IP
|
$262.99
|
|
| Hospital Charge Code |
901605691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$236.69 |
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Central Health Plan Commercial |
$210.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.20
|
| Rate for Payer: Galaxy Health WC |
$223.54
|
| Rate for Payer: Global Benefits Group Commercial |
$157.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$236.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$175.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.60
|
| Rate for Payer: Multiplan Commercial |
$197.24
|
| Rate for Payer: Networks By Design Commercial |
$170.94
|
| Rate for Payer: Prime Health Services Commercial |
$223.54
|
|
|
HC BAG EMPTY DIALYSIS STERILE
|
Facility
IP
|
$49.53
|
|
| Hospital Charge Code |
901601957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$44.58 |
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Central Health Plan Commercial |
$39.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.81
|
| Rate for Payer: Galaxy Health WC |
$42.10
|
| Rate for Payer: Global Benefits Group Commercial |
$29.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.91
|
| Rate for Payer: Multiplan Commercial |
$37.15
|
| Rate for Payer: Networks By Design Commercial |
$32.19
|
| Rate for Payer: Prime Health Services Commercial |
$42.10
|
|
|
HC BAG EMPTY DIALYSIS STERILE
|
Facility
OP
|
$49.53
|
|
| Hospital Charge Code |
901601957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$44.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.26
|
| Rate for Payer: BCBS Transplant Transplant |
$29.72
|
| Rate for Payer: Blue Shield of California Commercial |
$31.15
|
| Rate for Payer: Blue Shield of California EPN |
$24.22
|
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Central Health Plan Commercial |
$39.62
|
| Rate for Payer: Cigna of CA HMO |
$31.70
|
| Rate for Payer: Cigna of CA PPO |
$36.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.81
|
| Rate for Payer: Galaxy Health WC |
$42.10
|
| Rate for Payer: Global Benefits Group Commercial |
$29.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.15
|
| Rate for Payer: IEHP medi-cal |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.91
|
| Rate for Payer: Multiplan Commercial |
$37.15
|
| Rate for Payer: Networks By Design Commercial |
$32.19
|
| Rate for Payer: Prime Health Services Commercial |
$42.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$29.72
|
| Rate for Payer: Riverside University Health MISP |
$19.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.76
|
| Rate for Payer: United Healthcare All Other HMO |
$24.76
|
| Rate for Payer: United Healthcare HMO Rider |
$24.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.10
|
| Rate for Payer: Vantage Medical Group Senior |
$42.10
|
|
|
HC BAG FARRELL VALVE PEDIATRIC
|
Facility
OP
|
$59.45
|
|
| Hospital Charge Code |
901604602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$50.53
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$32.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.12
|
| Rate for Payer: BCBS Transplant Transplant |
$35.67
|
| Rate for Payer: Blue Shield of California Commercial |
$37.39
|
| Rate for Payer: Blue Shield of California EPN |
$29.07
|
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: Cigna of CA HMO |
$38.05
|
| Rate for Payer: Cigna of CA PPO |
$43.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$44.59
|
| Rate for Payer: IEHP medi-cal |
$20.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$35.67
|
| Rate for Payer: Riverside University Health MISP |
$23.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.72
|
| Rate for Payer: United Healthcare All Other HMO |
$29.72
|
| Rate for Payer: United Healthcare HMO Rider |
$29.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.53
|
| Rate for Payer: Vantage Medical Group Senior |
$50.53
|
|
|
HC BAG FARRELL VALVE PEDIATRIC
|
Facility
IP
|
$59.45
|
|
| Hospital Charge Code |
901604602
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Cash Price |
$26.75
|
| Rate for Payer: Central Health Plan Commercial |
$47.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: Galaxy Health WC |
$50.53
|
| Rate for Payer: Global Benefits Group Commercial |
$35.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.89
|
| Rate for Payer: Multiplan Commercial |
$44.59
|
| Rate for Payer: Networks By Design Commercial |
$38.64
|
| Rate for Payer: Prime Health Services Commercial |
$50.53
|
|
|
HC BAG FECAL COLLECT FLXSL
|
Facility
OP
|
$31.49
|
|
| Hospital Charge Code |
901605922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.60
|
| Rate for Payer: BCBS Transplant Transplant |
$18.89
|
| Rate for Payer: Blue Shield of California Commercial |
$19.81
|
| Rate for Payer: Blue Shield of California EPN |
$15.40
|
| Rate for Payer: Cash Price |
$14.17
|
| Rate for Payer: Central Health Plan Commercial |
$25.19
|
| Rate for Payer: Cigna of CA HMO |
$20.15
|
| Rate for Payer: Cigna of CA PPO |
$23.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.60
|
| Rate for Payer: Galaxy Health WC |
$26.77
|
| Rate for Payer: Global Benefits Group Commercial |
$18.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.62
|
| Rate for Payer: IEHP medi-cal |
$11.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.30
|
| Rate for Payer: Multiplan Commercial |
$23.62
|
| Rate for Payer: Networks By Design Commercial |
$20.47
|
| Rate for Payer: Prime Health Services Commercial |
$26.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.89
|
| Rate for Payer: Riverside University Health MISP |
$12.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.74
|
| Rate for Payer: United Healthcare All Other HMO |
$15.74
|
| Rate for Payer: United Healthcare HMO Rider |
$15.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.77
|
| Rate for Payer: Vantage Medical Group Senior |
$26.77
|
|
|
HC BAG FECAL COLLECT FLXSL
|
Facility
IP
|
$31.49
|
|
| Hospital Charge Code |
901605922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Cash Price |
$14.17
|
| Rate for Payer: Central Health Plan Commercial |
$25.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.60
|
| Rate for Payer: Galaxy Health WC |
$26.77
|
| Rate for Payer: Global Benefits Group Commercial |
$18.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.30
|
| Rate for Payer: Multiplan Commercial |
$23.62
|
| Rate for Payer: Networks By Design Commercial |
$20.47
|
| Rate for Payer: Prime Health Services Commercial |
$26.77
|
|
|
HC BAG FLEXISEAL COLLECTION
|
Facility
OP
|
$63.96
|
|
| Hospital Charge Code |
901698765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$57.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.79
|
| Rate for Payer: BCBS Transplant Transplant |
$38.38
|
| Rate for Payer: Blue Shield of California Commercial |
$40.23
|
| Rate for Payer: Blue Shield of California EPN |
$31.28
|
| Rate for Payer: Cash Price |
$28.78
|
| Rate for Payer: Central Health Plan Commercial |
$51.17
|
| Rate for Payer: Cigna of CA HMO |
$40.93
|
| Rate for Payer: Cigna of CA PPO |
$47.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.58
|
| Rate for Payer: Galaxy Health WC |
$54.37
|
| Rate for Payer: Global Benefits Group Commercial |
$38.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$47.97
|
| Rate for Payer: IEHP medi-cal |
$22.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.79
|
| Rate for Payer: Multiplan Commercial |
$47.97
|
| Rate for Payer: Networks By Design Commercial |
$41.57
|
| Rate for Payer: Prime Health Services Commercial |
$54.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$38.38
|
| Rate for Payer: Riverside University Health MISP |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.98
|
| Rate for Payer: United Healthcare All Other HMO |
$31.98
|
| Rate for Payer: United Healthcare HMO Rider |
$31.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.37
|
| Rate for Payer: Vantage Medical Group Senior |
$54.37
|
|
|
HC BAG FLEXISEAL COLLECTION
|
Facility
IP
|
$63.96
|
|
| Hospital Charge Code |
901698765
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$57.56 |
| Rate for Payer: Cash Price |
$28.78
|
| Rate for Payer: Central Health Plan Commercial |
$51.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.58
|
| Rate for Payer: Galaxy Health WC |
$54.37
|
| Rate for Payer: Global Benefits Group Commercial |
$38.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.79
|
| Rate for Payer: Multiplan Commercial |
$47.97
|
| Rate for Payer: Networks By Design Commercial |
$41.57
|
| Rate for Payer: Prime Health Services Commercial |
$54.37
|
|
|
HC BAG FLEXISEAL PRIVACY
|
Facility
IP
|
$30.34
|
|
| Hospital Charge Code |
901606802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC BAG FLEXISEAL PRIVACY
|
Facility
OP
|
$30.34
|
|
| Hospital Charge Code |
901606802
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.92
|
| Rate for Payer: BCBS Transplant Transplant |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.84
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.76
|
| Rate for Payer: IEHP medi-cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: Riverside University Health MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC BAG TRU-CLOSE 1000ML SUCTION
|
Facility
OP
|
$334.67
|
|
| Hospital Charge Code |
901604143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.93 |
| Max. Negotiated Rate |
$301.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$203.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$284.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$184.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$184.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.72
|
| Rate for Payer: BCBS Transplant Transplant |
$200.80
|
| Rate for Payer: Blue Shield of California Commercial |
$210.51
|
| Rate for Payer: Blue Shield of California EPN |
$163.65
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Central Health Plan Commercial |
$267.74
|
| Rate for Payer: Cigna of CA HMO |
$214.19
|
| Rate for Payer: Cigna of CA PPO |
$247.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$284.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$133.87
|
| Rate for Payer: Galaxy Health WC |
$284.47
|
| Rate for Payer: Global Benefits Group Commercial |
$200.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$301.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$251.00
|
| Rate for Payer: IEHP medi-cal |
$117.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$223.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.93
|
| Rate for Payer: Multiplan Commercial |
$251.00
|
| Rate for Payer: Networks By Design Commercial |
$217.54
|
| Rate for Payer: Prime Health Services Commercial |
$284.47
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$200.80
|
| Rate for Payer: Riverside University Health MISP |
$133.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$167.34
|
| Rate for Payer: United Healthcare All Other HMO |
$167.34
|
| Rate for Payer: United Healthcare HMO Rider |
$167.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$167.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$284.47
|
| Rate for Payer: Vantage Medical Group Senior |
$284.47
|
|
|
HC BAG TRU-CLOSE 1000ML SUCTION
|
Facility
IP
|
$334.67
|
|
| Hospital Charge Code |
901604143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.93 |
| Max. Negotiated Rate |
$301.20 |
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Central Health Plan Commercial |
$267.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.87
|
| Rate for Payer: Galaxy Health WC |
$284.47
|
| Rate for Payer: Global Benefits Group Commercial |
$200.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$301.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$223.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.93
|
| Rate for Payer: Multiplan Commercial |
$251.00
|
| Rate for Payer: Networks By Design Commercial |
$217.54
|
| Rate for Payer: Prime Health Services Commercial |
$284.47
|
|
|
HC BAG TRU-CLOSE 600ML GRAVITY
|
Facility
IP
|
$128.06
|
|
| Hospital Charge Code |
901604505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.61 |
| Max. Negotiated Rate |
$115.25 |
| Rate for Payer: Cash Price |
$57.63
|
| Rate for Payer: Central Health Plan Commercial |
$102.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.22
|
| Rate for Payer: Galaxy Health WC |
$108.85
|
| Rate for Payer: Global Benefits Group Commercial |
$76.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.61
|
| Rate for Payer: Multiplan Commercial |
$96.04
|
| Rate for Payer: Networks By Design Commercial |
$83.24
|
| Rate for Payer: Prime Health Services Commercial |
$108.85
|
|
|
HC BAG TRU-CLOSE 600ML GRAVITY
|
Facility
OP
|
$128.06
|
|
| Hospital Charge Code |
901604505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.61 |
| Max. Negotiated Rate |
$115.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$108.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$70.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$70.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.66
|
| Rate for Payer: BCBS Transplant Transplant |
$76.84
|
| Rate for Payer: Blue Shield of California Commercial |
$80.55
|
| Rate for Payer: Blue Shield of California EPN |
$62.62
|
| Rate for Payer: Cash Price |
$57.63
|
| Rate for Payer: Central Health Plan Commercial |
$102.45
|
| Rate for Payer: Cigna of CA HMO |
$81.96
|
| Rate for Payer: Cigna of CA PPO |
$94.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$108.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.22
|
| Rate for Payer: Galaxy Health WC |
$108.85
|
| Rate for Payer: Global Benefits Group Commercial |
$76.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$96.04
|
| Rate for Payer: IEHP medi-cal |
$44.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.61
|
| Rate for Payer: Multiplan Commercial |
$96.04
|
| Rate for Payer: Networks By Design Commercial |
$83.24
|
| Rate for Payer: Prime Health Services Commercial |
$108.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$76.84
|
| Rate for Payer: Riverside University Health MISP |
$51.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.03
|
| Rate for Payer: United Healthcare All Other HMO |
$64.03
|
| Rate for Payer: United Healthcare HMO Rider |
$64.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.85
|
| Rate for Payer: Vantage Medical Group Senior |
$108.85
|
|
|
HC BAG URETERAL DRAINAGE
|
Facility
IP
|
$24.00
|
|
| Hospital Charge Code |
909001074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC BAG URETERAL DRAINAGE
|
Facility
OP
|
$24.00
|
|
| Hospital Charge Code |
909001074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.18
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15.10
|
| Rate for Payer: Blue Shield of California EPN |
$11.74
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: IEHP medi-cal |
$8.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: Riverside University Health MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC BAG URINE CONVEEN LEG BAG
|
Facility
OP
|
$52.23
|
|
| Hospital Charge Code |
901602500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$47.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$28.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.86
|
| Rate for Payer: BCBS Transplant Transplant |
$31.34
|
| Rate for Payer: Blue Shield of California Commercial |
$32.85
|
| Rate for Payer: Blue Shield of California EPN |
$25.54
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Central Health Plan Commercial |
$41.78
|
| Rate for Payer: Cigna of CA HMO |
$33.43
|
| Rate for Payer: Cigna of CA PPO |
$38.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$39.17
|
| Rate for Payer: IEHP medi-cal |
$18.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.45
|
| Rate for Payer: Multiplan Commercial |
$39.17
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31.34
|
| Rate for Payer: Riverside University Health MISP |
$20.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.12
|
| Rate for Payer: United Healthcare All Other HMO |
$26.12
|
| Rate for Payer: United Healthcare HMO Rider |
$26.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.40
|
| Rate for Payer: Vantage Medical Group Senior |
$44.40
|
|
|
HC BAG URINE CONVEEN LEG BAG
|
Facility
IP
|
$52.23
|
|
| Hospital Charge Code |
901602500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$47.01 |
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Central Health Plan Commercial |
$41.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.89
|
| Rate for Payer: Galaxy Health WC |
$44.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.45
|
| Rate for Payer: Multiplan Commercial |
$39.17
|
| Rate for Payer: Networks By Design Commercial |
$33.95
|
| Rate for Payer: Prime Health Services Commercial |
$44.40
|
|
|
HC BAG VNTRL WALL DFCT SILO 10CM
|
Facility
IP
|
$1,989.27
|
|
| Hospital Charge Code |
901604783
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$397.85 |
| Max. Negotiated Rate |
$1,790.34 |
| Rate for Payer: Cash Price |
$895.17
|
| Rate for Payer: Central Health Plan Commercial |
$1,591.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$795.71
|
| Rate for Payer: Galaxy Health WC |
$1,690.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,193.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,790.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,326.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.85
|
| Rate for Payer: Multiplan Commercial |
$1,491.95
|
| Rate for Payer: Networks By Design Commercial |
$1,293.03
|
| Rate for Payer: Prime Health Services Commercial |
$1,690.88
|
|
|
HC BAG VNTRL WALL DFCT SILO 10CM
|
Facility
OP
|
$1,989.27
|
|
| Hospital Charge Code |
901604783
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$397.85 |
| Max. Negotiated Rate |
$1,790.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,208.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,690.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,094.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,094.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$963.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,175.26
|
| Rate for Payer: BCBS Transplant Transplant |
$1,193.56
|
| Rate for Payer: Blue Shield of California Commercial |
$1,251.25
|
| Rate for Payer: Blue Shield of California EPN |
$972.75
|
| Rate for Payer: Cash Price |
$895.17
|
| Rate for Payer: Central Health Plan Commercial |
$1,591.42
|
| Rate for Payer: Cigna of CA HMO |
$1,273.13
|
| Rate for Payer: Cigna of CA PPO |
$1,472.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,690.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$795.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$795.71
|
| Rate for Payer: Galaxy Health WC |
$1,690.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,193.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,790.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,491.95
|
| Rate for Payer: IEHP medi-cal |
$696.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,326.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$397.85
|
| Rate for Payer: Multiplan Commercial |
$1,491.95
|
| Rate for Payer: Networks By Design Commercial |
$1,293.03
|
| Rate for Payer: Prime Health Services Commercial |
$1,690.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,193.56
|
| Rate for Payer: Riverside University Health MISP |
$795.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,193.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,193.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$994.64
|
| Rate for Payer: United Healthcare All Other HMO |
$994.64
|
| Rate for Payer: United Healthcare HMO Rider |
$994.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$994.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,690.88
|
| Rate for Payer: Vantage Medical Group Senior |
$1,690.88
|
|
