|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Adventist Health Commercial |
$236.00
|
| Rate for Payer: Cash Price |
$649.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$472.00
|
| Rate for Payer: EPIC Health Plan Senior |
$472.00
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$787.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$449.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$730.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
|
|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$236.00
|
| 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 |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$649.00
|
| Rate for Payer: Cash Price |
$649.00
|
| Rate for Payer: Cash Price |
$649.00
|
| Rate for Payer: Cash Price |
$649.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: Cigna of CA HMO |
$755.20
|
| Rate for Payer: Cigna of CA PPO |
$873.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$787.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$708.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.00
|
| Rate for Payer: United Healthcare All Other HMO |
$590.00
|
| Rate for Payer: United Healthcare HMO Rider |
$590.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$590.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC DRAIN EXTERNAL PEDS BAXTER
|
Facility
|
IP
|
$1,274.20
|
|
| Hospital Charge Code |
901603691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.84 |
| Max. Negotiated Rate |
$1,146.78 |
| Rate for Payer: Adventist Health Commercial |
$254.84
|
| Rate for Payer: Cash Price |
$700.81
|
| Rate for Payer: Central Health Plan Commercial |
$1,019.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$509.68
|
| Rate for Payer: EPIC Health Plan Senior |
$509.68
|
| Rate for Payer: Galaxy Health WC |
$1,083.07
|
| Rate for Payer: Global Benefits Group Commercial |
$764.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,146.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$849.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$788.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.84
|
| Rate for Payer: Multiplan Commercial |
$955.65
|
| Rate for Payer: Networks By Design Commercial |
$828.23
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.07
|
|
|
HC DRAIN EXTERNAL PEDS BAXTER
|
Facility
|
OP
|
$1,274.20
|
|
| Hospital Charge Code |
901603691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.84 |
| Max. Negotiated Rate |
$1,146.78 |
| Rate for Payer: Adventist Health Commercial |
$254.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$773.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$700.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$955.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$616.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$748.34
|
| Rate for Payer: Blue Shield of California Commercial |
$778.54
|
| Rate for Payer: Blue Shield of California EPN |
$508.41
|
| Rate for Payer: Cash Price |
$700.81
|
| Rate for Payer: Central Health Plan Commercial |
$1,019.36
|
| Rate for Payer: Cigna of CA HMO |
$815.49
|
| Rate for Payer: Cigna of CA PPO |
$942.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,083.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,083.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$509.68
|
| Rate for Payer: EPIC Health Plan Senior |
$509.68
|
| Rate for Payer: Galaxy Health WC |
$1,083.07
|
| Rate for Payer: Global Benefits Group Commercial |
$764.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,146.78
|
| Rate for Payer: InnovAge PACE Commercial |
$637.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$849.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$788.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$891.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$891.94
|
| Rate for Payer: Multiplan Commercial |
$955.65
|
| Rate for Payer: Networks By Design Commercial |
$828.23
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.07
|
| Rate for Payer: Riverside University Health System MISP |
$509.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$764.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$764.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$637.10
|
| Rate for Payer: United Healthcare All Other HMO |
$637.10
|
| Rate for Payer: United Healthcare HMO Rider |
$637.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$637.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,083.07
|
| Rate for Payer: Vantage Medical Group Senior |
$1,083.07
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
IP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,139.00 |
| Max. Negotiated Rate |
$5,125.50 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,278.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,278.00
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,798.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,169.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,525.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
IP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,139.00 |
| Max. Negotiated Rate |
$5,125.50 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,278.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,278.00
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,798.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,169.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,525.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
OP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$269.51 |
| Max. Negotiated Rate |
$5,125.50 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| 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 |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Cigna of CA HMO |
$3,644.80
|
| Rate for Payer: Cigna of CA PPO |
$4,214.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,798.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$269.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,417.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,847.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,847.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,847.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,847.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
OP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$269.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$2,334.95
|
| 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 |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Cash Price |
$3,132.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Cigna of CA HMO |
$3,644.80
|
| Rate for Payer: Cigna of CA PPO |
$4,214.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,798.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$269.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,417.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,417.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
OP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.78 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Cigna of CA HMO |
$851.84
|
| Rate for Payer: Cigna of CA PPO |
$984.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$887.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$798.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$665.50
|
| Rate for Payer: United Healthcare All Other HMO |
$665.50
|
| Rate for Payer: United Healthcare HMO Rider |
$665.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$665.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
IP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$266.20 |
| Max. Negotiated Rate |
$1,197.90 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$532.40
|
| Rate for Payer: EPIC Health Plan Senior |
$532.40
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$887.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$507.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$823.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
IP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$266.20 |
| Max. Negotiated Rate |
$1,197.90 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$532.40
|
| Rate for Payer: EPIC Health Plan Senior |
$532.40
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$887.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$507.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$823.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
OP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$198.78 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$545.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$808.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$781.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Cash Price |
$732.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Cigna of CA HMO |
$851.84
|
| Rate for Payer: Cigna of CA PPO |
$984.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$887.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$798.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$798.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC DRAIN FLAT 10FR W/TROCAR
|
Facility
|
IP
|
$196.14
|
|
| Hospital Charge Code |
901603860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.23 |
| Max. Negotiated Rate |
$176.53 |
| Rate for Payer: Adventist Health Commercial |
$39.23
|
| Rate for Payer: Cash Price |
$107.88
|
| Rate for Payer: Central Health Plan Commercial |
$156.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.46
|
| Rate for Payer: EPIC Health Plan Senior |
$78.46
|
| Rate for Payer: Galaxy Health WC |
$166.72
|
| Rate for Payer: Global Benefits Group Commercial |
$117.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.23
|
| Rate for Payer: Multiplan Commercial |
$147.10
|
| Rate for Payer: Networks By Design Commercial |
$127.49
|
| Rate for Payer: Prime Health Services Commercial |
$166.72
|
|
|
HC DRAIN FLAT 10FR W/TROCAR
|
Facility
|
OP
|
$196.14
|
|
| Hospital Charge Code |
901603860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.23 |
| Max. Negotiated Rate |
$176.53 |
| Rate for Payer: Adventist Health Commercial |
$39.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.19
|
| Rate for Payer: Blue Shield of California Commercial |
$119.84
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$107.88
|
| Rate for Payer: Central Health Plan Commercial |
$156.91
|
| Rate for Payer: Cigna of CA HMO |
$125.53
|
| Rate for Payer: Cigna of CA PPO |
$145.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.46
|
| Rate for Payer: EPIC Health Plan Senior |
$78.46
|
| Rate for Payer: Galaxy Health WC |
$166.72
|
| Rate for Payer: Global Benefits Group Commercial |
$117.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.53
|
| Rate for Payer: InnovAge PACE Commercial |
$98.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.30
|
| Rate for Payer: Multiplan Commercial |
$147.10
|
| Rate for Payer: Networks By Design Commercial |
$127.49
|
| Rate for Payer: Prime Health Services Commercial |
$166.72
|
| Rate for Payer: Riverside University Health System MISP |
$78.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.07
|
| Rate for Payer: United Healthcare All Other HMO |
$98.07
|
| Rate for Payer: United Healthcare HMO Rider |
$98.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.72
|
| Rate for Payer: Vantage Medical Group Senior |
$166.72
|
|
|
HC DRAIN HEMOVAC 1/8" CLSD SCTN
|
Facility
|
OP
|
$23.70
|
|
| Hospital Charge Code |
901605639
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.92
|
| Rate for Payer: Blue Shield of California Commercial |
$14.48
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Cigna of CA HMO |
$15.17
|
| Rate for Payer: Cigna of CA PPO |
$17.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: InnovAge PACE Commercial |
$11.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.59
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO |
$11.85
|
| Rate for Payer: United Healthcare HMO Rider |
$11.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.14
|
|
|
HC DRAIN HEMOVAC 1/8" CLSD SCTN
|
Facility
|
IP
|
$23.70
|
|
| Hospital Charge Code |
901605639
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
|
HC DRAIN JP
|
Facility
|
OP
|
$35.09
|
|
| Hospital Charge Code |
909020083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$31.58 |
| Rate for Payer: Adventist Health Commercial |
$7.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.61
|
| Rate for Payer: Blue Shield of California Commercial |
$21.44
|
| Rate for Payer: Blue Shield of California EPN |
$14.00
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Central Health Plan Commercial |
$28.07
|
| Rate for Payer: Cigna of CA HMO |
$22.46
|
| Rate for Payer: Cigna of CA PPO |
$25.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.04
|
| Rate for Payer: EPIC Health Plan Senior |
$14.04
|
| Rate for Payer: Galaxy Health WC |
$29.83
|
| Rate for Payer: Global Benefits Group Commercial |
$21.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.58
|
| Rate for Payer: InnovAge PACE Commercial |
$17.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.56
|
| Rate for Payer: Multiplan Commercial |
$26.32
|
| Rate for Payer: Networks By Design Commercial |
$22.81
|
| Rate for Payer: Prime Health Services Commercial |
$29.83
|
| Rate for Payer: Riverside University Health System MISP |
$14.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.55
|
| Rate for Payer: United Healthcare All Other HMO |
$17.55
|
| Rate for Payer: United Healthcare HMO Rider |
$17.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.83
|
| Rate for Payer: Vantage Medical Group Senior |
$29.83
|
|
|
HC DRAIN JP
|
Facility
|
IP
|
$35.09
|
|
| Hospital Charge Code |
909020083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$31.58 |
| Rate for Payer: Adventist Health Commercial |
$7.02
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Central Health Plan Commercial |
$28.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.04
|
| Rate for Payer: EPIC Health Plan Senior |
$14.04
|
| Rate for Payer: Galaxy Health WC |
$29.83
|
| Rate for Payer: Global Benefits Group Commercial |
$21.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.02
|
| Rate for Payer: Multiplan Commercial |
$26.32
|
| Rate for Payer: Networks By Design Commercial |
$22.81
|
| Rate for Payer: Prime Health Services Commercial |
$29.83
|
|
|
HC DRAIN LUMBAR LIMITORR 20ML
|
Facility
|
IP
|
$1,540.13
|
|
| Hospital Charge Code |
901605690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$308.03 |
| Max. Negotiated Rate |
$1,386.12 |
| Rate for Payer: Adventist Health Commercial |
$308.03
|
| Rate for Payer: Cash Price |
$847.07
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.05
|
| Rate for Payer: EPIC Health Plan Senior |
$616.05
|
| Rate for Payer: Galaxy Health WC |
$1,309.11
|
| Rate for Payer: Global Benefits Group Commercial |
$924.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$586.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.03
|
| Rate for Payer: Multiplan Commercial |
$1,155.10
|
| Rate for Payer: Networks By Design Commercial |
$1,001.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.11
|
|
|
HC DRAIN LUMBAR LIMITORR 20ML
|
Facility
|
OP
|
$1,540.13
|
|
| Hospital Charge Code |
901605690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$308.03 |
| Max. Negotiated Rate |
$1,386.12 |
| Rate for Payer: Adventist Health Commercial |
$308.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$935.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,309.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$847.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,155.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$745.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$904.52
|
| Rate for Payer: Blue Shield of California Commercial |
$941.02
|
| Rate for Payer: Blue Shield of California EPN |
$614.51
|
| Rate for Payer: Cash Price |
$847.07
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.10
|
| Rate for Payer: Cigna of CA HMO |
$985.68
|
| Rate for Payer: Cigna of CA PPO |
$1,139.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,309.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,309.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,309.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.05
|
| Rate for Payer: EPIC Health Plan Senior |
$616.05
|
| Rate for Payer: Galaxy Health WC |
$1,309.11
|
| Rate for Payer: Global Benefits Group Commercial |
$924.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.12
|
| Rate for Payer: InnovAge PACE Commercial |
$770.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$586.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,078.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,078.09
|
| Rate for Payer: Multiplan Commercial |
$1,155.10
|
| Rate for Payer: Networks By Design Commercial |
$1,001.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.11
|
| Rate for Payer: Riverside University Health System MISP |
$616.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$770.07
|
| Rate for Payer: United Healthcare All Other HMO |
$770.07
|
| Rate for Payer: United Healthcare HMO Rider |
$770.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$770.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,309.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,309.11
|
| Rate for Payer: Vantage Medical Group Senior |
$1,309.11
|
|
|
HC DRAIN LUMBAR LIMITORR 30ML
|
Facility
|
OP
|
$1,267.81
|
|
| Hospital Charge Code |
901698150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.56 |
| Max. Negotiated Rate |
$1,141.03 |
| Rate for Payer: Adventist Health Commercial |
$253.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$769.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,077.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$697.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$950.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$613.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$744.58
|
| Rate for Payer: Blue Shield of California Commercial |
$774.63
|
| Rate for Payer: Blue Shield of California EPN |
$505.86
|
| Rate for Payer: Cash Price |
$697.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,014.25
|
| Rate for Payer: Cigna of CA HMO |
$811.40
|
| Rate for Payer: Cigna of CA PPO |
$938.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,077.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,077.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,077.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$507.12
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$1,077.64
|
| Rate for Payer: Global Benefits Group Commercial |
$760.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,141.03
|
| Rate for Payer: InnovAge PACE Commercial |
$633.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$483.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$887.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$887.47
|
| Rate for Payer: Multiplan Commercial |
$950.86
|
| Rate for Payer: Networks By Design Commercial |
$824.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,077.64
|
| Rate for Payer: Riverside University Health System MISP |
$507.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$760.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$760.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$633.90
|
| Rate for Payer: United Healthcare All Other HMO |
$633.90
|
| Rate for Payer: United Healthcare HMO Rider |
$633.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$633.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,077.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,077.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,077.64
|
|
|
HC DRAIN LUMBAR LIMITORR 30ML
|
Facility
|
IP
|
$1,267.81
|
|
| Hospital Charge Code |
901698150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.56 |
| Max. Negotiated Rate |
$1,141.03 |
| Rate for Payer: Adventist Health Commercial |
$253.56
|
| Rate for Payer: Cash Price |
$697.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,014.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$507.12
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$1,077.64
|
| Rate for Payer: Global Benefits Group Commercial |
$760.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,141.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$845.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$483.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.56
|
| Rate for Payer: Multiplan Commercial |
$950.86
|
| Rate for Payer: Networks By Design Commercial |
$824.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,077.64
|
|
|
HC DRAIN PENROSE 12X1/2" STD STRL
|
Facility
|
OP
|
$23.29
|
|
| Hospital Charge Code |
901698440
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$20.96 |
| Rate for Payer: Adventist Health Commercial |
$4.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.68
|
| Rate for Payer: Blue Shield of California Commercial |
$14.23
|
| Rate for Payer: Blue Shield of California EPN |
$9.29
|
| Rate for Payer: Cash Price |
$12.81
|
| Rate for Payer: Central Health Plan Commercial |
$18.63
|
| Rate for Payer: Cigna of CA HMO |
$14.91
|
| Rate for Payer: Cigna of CA PPO |
$17.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.32
|
| Rate for Payer: EPIC Health Plan Senior |
$9.32
|
| Rate for Payer: Galaxy Health WC |
$19.80
|
| Rate for Payer: Global Benefits Group Commercial |
$13.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.96
|
| Rate for Payer: InnovAge PACE Commercial |
$11.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.30
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: Networks By Design Commercial |
$15.14
|
| Rate for Payer: Prime Health Services Commercial |
$19.80
|
| Rate for Payer: Riverside University Health System MISP |
$9.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.64
|
| Rate for Payer: United Healthcare All Other HMO |
$11.64
|
| Rate for Payer: United Healthcare HMO Rider |
$11.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: Vantage Medical Group Senior |
$19.80
|
|
|
HC DRAIN PENROSE 12X1/2" STD STRL
|
Facility
|
IP
|
$23.29
|
|
| Hospital Charge Code |
901698440
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$20.96 |
| Rate for Payer: Adventist Health Commercial |
$4.66
|
| Rate for Payer: Cash Price |
$12.81
|
| Rate for Payer: Central Health Plan Commercial |
$18.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.32
|
| Rate for Payer: EPIC Health Plan Senior |
$9.32
|
| Rate for Payer: Galaxy Health WC |
$19.80
|
| Rate for Payer: Global Benefits Group Commercial |
$13.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$17.47
|
| Rate for Payer: Networks By Design Commercial |
$15.14
|
| Rate for Payer: Prime Health Services Commercial |
$19.80
|
|
|
HC DRAIN PENROSE 1/2 X 12" STERL
|
Facility
|
OP
|
$9.43
|
|
| Hospital Charge Code |
901601235
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Adventist Health Commercial |
$1.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.54
|
| Rate for Payer: Blue Shield of California Commercial |
$5.76
|
| Rate for Payer: Blue Shield of California EPN |
$3.76
|
| Rate for Payer: Cash Price |
$5.19
|
| Rate for Payer: Central Health Plan Commercial |
$7.54
|
| Rate for Payer: Cigna of CA HMO |
$6.04
|
| Rate for Payer: Cigna of CA PPO |
$6.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.77
|
| Rate for Payer: EPIC Health Plan Senior |
$3.77
|
| Rate for Payer: Galaxy Health WC |
$8.02
|
| Rate for Payer: Global Benefits Group Commercial |
$5.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.49
|
| Rate for Payer: InnovAge PACE Commercial |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$7.07
|
| Rate for Payer: Networks By Design Commercial |
$6.13
|
| Rate for Payer: Prime Health Services Commercial |
$8.02
|
| Rate for Payer: Riverside University Health System MISP |
$3.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.71
|
| Rate for Payer: United Healthcare All Other HMO |
$4.71
|
| Rate for Payer: United Healthcare HMO Rider |
$4.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
