|
HC COIL AXIUM 3D
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020107
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC COIL AXIUM 3D
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020107
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL CASHMERE
|
Facility
OP
|
$4,575.00
|
|
| Hospital Charge Code |
909020101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$915.00 |
| Max. Negotiated Rate |
$4,117.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,778.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,888.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,516.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,516.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,215.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,702.91
|
| Rate for Payer: BCBS Transplant Transplant |
$2,745.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,877.68
|
| Rate for Payer: Blue Shield of California EPN |
$2,237.18
|
| Rate for Payer: Cash Price |
$2,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,660.00
|
| Rate for Payer: Cigna of CA HMO |
$2,928.00
|
| Rate for Payer: Cigna of CA PPO |
$3,385.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,888.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,830.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,830.00
|
| Rate for Payer: Galaxy Health WC |
$3,888.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,745.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,117.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,431.25
|
| Rate for Payer: IEHP medi-cal |
$1,601.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,051.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$915.00
|
| Rate for Payer: Multiplan Commercial |
$3,431.25
|
| Rate for Payer: Networks By Design Commercial |
$2,973.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,888.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,745.00
|
| Rate for Payer: Riverside University Health MISP |
$1,830.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,745.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,745.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,287.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,287.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,287.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,888.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,888.75
|
|
|
HC COIL CASHMERE
|
Facility
IP
|
$4,575.00
|
|
| Hospital Charge Code |
909020101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$915.00 |
| Max. Negotiated Rate |
$4,117.50 |
| Rate for Payer: Cash Price |
$2,058.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,660.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,830.00
|
| Rate for Payer: Galaxy Health WC |
$3,888.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,745.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,117.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,051.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$915.00
|
| Rate for Payer: Multiplan Commercial |
$3,431.25
|
| Rate for Payer: Networks By Design Commercial |
$2,973.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,888.75
|
|
|
HC COIL DELTA PLUSH
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL DELTA PLUSH
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC COIL GDC-10
|
Facility
OP
|
$4,850.00
|
|
| Hospital Charge Code |
909020104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$970.00 |
| Max. Negotiated Rate |
$4,365.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,945.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,122.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,667.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,667.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,348.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,865.38
|
| Rate for Payer: BCBS Transplant Transplant |
$2,910.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,050.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,371.65
|
| Rate for Payer: Cash Price |
$2,182.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,880.00
|
| Rate for Payer: Cigna of CA HMO |
$3,104.00
|
| Rate for Payer: Cigna of CA PPO |
$3,589.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,122.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,940.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,940.00
|
| Rate for Payer: Galaxy Health WC |
$4,122.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,910.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,365.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,637.50
|
| Rate for Payer: IEHP medi-cal |
$1,697.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,234.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$970.00
|
| Rate for Payer: Multiplan Commercial |
$3,637.50
|
| Rate for Payer: Networks By Design Commercial |
$3,152.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,122.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,910.00
|
| Rate for Payer: Riverside University Health MISP |
$1,940.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,910.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,910.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,425.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,425.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,425.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,122.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.50
|
|
|
HC COIL GDC-10
|
Facility
IP
|
$4,850.00
|
|
| Hospital Charge Code |
909020104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$970.00 |
| Max. Negotiated Rate |
$4,365.00 |
| Rate for Payer: Cash Price |
$2,182.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,880.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,940.00
|
| Rate for Payer: Galaxy Health WC |
$4,122.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,910.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,234.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$970.00
|
| Rate for Payer: Multiplan Commercial |
$3,637.50
|
| Rate for Payer: Networks By Design Commercial |
$3,152.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,122.50
|
|
|
HC COIL GDC-18 FIBERED
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL GDC-18 FIBERED
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC COIL GDC 360 STANDARD
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC COIL GDC 360 STANDARD
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL MICROVENTION HYPERSOFT
|
Facility
IP
|
$3,783.00
|
|
| Hospital Charge Code |
909020123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$756.60 |
| Max. Negotiated Rate |
$3,404.70 |
| Rate for Payer: Cash Price |
$1,702.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,026.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,513.20
|
| Rate for Payer: Galaxy Health WC |
$3,215.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,269.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,404.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,523.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$756.60
|
| Rate for Payer: Multiplan Commercial |
$2,837.25
|
| Rate for Payer: Networks By Design Commercial |
$2,458.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,215.55
|
|
|
HC COIL MICROVENTION HYPERSOFT
|
Facility
OP
|
$3,783.00
|
|
| Hospital Charge Code |
909020123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$756.60 |
| Max. Negotiated Rate |
$3,404.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,297.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,215.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,080.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,080.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,831.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,235.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,269.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,379.51
|
| Rate for Payer: Blue Shield of California EPN |
$1,849.89
|
| Rate for Payer: Cash Price |
$1,702.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,026.40
|
| Rate for Payer: Cigna of CA HMO |
$2,421.12
|
| Rate for Payer: Cigna of CA PPO |
$2,799.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,215.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,513.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,513.20
|
| Rate for Payer: Galaxy Health WC |
$3,215.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,269.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,404.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,837.25
|
| Rate for Payer: IEHP medi-cal |
$1,324.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,523.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$756.60
|
| Rate for Payer: Multiplan Commercial |
$2,837.25
|
| Rate for Payer: Networks By Design Commercial |
$2,458.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,215.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,269.80
|
| Rate for Payer: Riverside University Health MISP |
$1,513.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,269.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,269.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,891.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,891.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,891.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,891.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,215.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,215.55
|
|
|
HC COIL MICROVENTN HYDROSFT 10-30
|
Facility
IP
|
$4,875.00
|
|
| Hospital Charge Code |
909020125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$3,168.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
|
|
HC COIL MICROVENTN HYDROSFT 10-30
|
Facility
OP
|
$4,875.00
|
|
| Hospital Charge Code |
909020125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,960.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,681.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,360.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,880.15
|
| Rate for Payer: BCBS Transplant Transplant |
$2,925.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,066.38
|
| Rate for Payer: Blue Shield of California EPN |
$2,383.88
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,120.00
|
| Rate for Payer: Cigna of CA PPO |
$3,607.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,656.25
|
| Rate for Payer: IEHP medi-cal |
$1,706.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$3,168.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: Riverside University Health MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC COIL MICROVENTN HYDROSFT 4-8CM
|
Facility
OP
|
$4,000.00
|
|
| Hospital Charge Code |
909020124
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$800.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,429.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,400.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,200.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,200.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,936.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,363.20
|
| Rate for Payer: BCBS Transplant Transplant |
$2,400.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,516.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,956.00
|
| Rate for Payer: Cash Price |
$1,800.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,200.00
|
| Rate for Payer: Cigna of CA HMO |
$2,560.00
|
| Rate for Payer: Cigna of CA PPO |
$2,960.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,600.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,600.00
|
| Rate for Payer: Galaxy Health WC |
$3,400.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,400.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,600.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,000.00
|
| Rate for Payer: IEHP medi-cal |
$1,400.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,668.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.00
|
| Rate for Payer: Multiplan Commercial |
$3,000.00
|
| Rate for Payer: Networks By Design Commercial |
$2,600.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,400.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,400.00
|
| Rate for Payer: Riverside University Health MISP |
$1,600.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,400.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,400.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,000.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,000.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,000.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,400.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,400.00
|
|
|
HC COIL MICROVENTN HYDROSFT 4-8CM
|
Facility
IP
|
$4,000.00
|
|
| Hospital Charge Code |
909020124
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$800.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Cash Price |
$1,800.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,200.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,600.00
|
| Rate for Payer: Galaxy Health WC |
$3,400.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,400.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,668.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.00
|
| Rate for Payer: Multiplan Commercial |
$3,000.00
|
| Rate for Payer: Networks By Design Commercial |
$2,600.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,400.00
|
|
|
HC COIL, MICRUSHERE
|
Facility
IP
|
$4,075.00
|
|
| Hospital Charge Code |
909020102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$815.00 |
| Max. Negotiated Rate |
$3,667.50 |
| Rate for Payer: Cash Price |
$1,833.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,260.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.00
|
| Rate for Payer: Galaxy Health WC |
$3,463.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,667.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$815.00
|
| Rate for Payer: Multiplan Commercial |
$3,056.25
|
| Rate for Payer: Networks By Design Commercial |
$2,648.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,463.75
|
|
|
HC COIL, MICRUSHERE
|
Facility
OP
|
$4,075.00
|
|
| Hospital Charge Code |
909020102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$815.00 |
| Max. Negotiated Rate |
$3,667.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,474.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,463.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,241.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,241.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,973.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,407.51
|
| Rate for Payer: BCBS Transplant Transplant |
$2,445.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,563.18
|
| Rate for Payer: Blue Shield of California EPN |
$1,992.68
|
| Rate for Payer: Cash Price |
$1,833.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,260.00
|
| Rate for Payer: Cigna of CA HMO |
$2,608.00
|
| Rate for Payer: Cigna of CA PPO |
$3,015.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,463.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,630.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,630.00
|
| Rate for Payer: Galaxy Health WC |
$3,463.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,667.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,056.25
|
| Rate for Payer: IEHP medi-cal |
$1,426.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,718.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$815.00
|
| Rate for Payer: Multiplan Commercial |
$3,056.25
|
| Rate for Payer: Networks By Design Commercial |
$2,648.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,463.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,445.00
|
| Rate for Payer: Riverside University Health MISP |
$1,630.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,445.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,445.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,037.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,037.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,037.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,037.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,463.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,463.75
|
|
|
HC COIL ORBIT J & J
|
Facility
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,172.30
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,925.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,121.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL ORBIT J & J
|
Facility
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,082.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC COIL PENUMBRA
|
Facility
OP
|
$6,750.00
|
|
| Hospital Charge Code |
909020118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$6,075.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,099.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,737.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,712.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,712.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,268.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,987.90
|
| Rate for Payer: BCBS Transplant Transplant |
$4,050.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,300.75
|
| Rate for Payer: Cash Price |
$3,037.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,400.00
|
| Rate for Payer: Cigna of CA HMO |
$4,320.00
|
| Rate for Payer: Cigna of CA PPO |
$4,995.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,737.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,700.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,700.00
|
| Rate for Payer: Galaxy Health WC |
$5,737.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,050.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,075.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,062.50
|
| Rate for Payer: IEHP medi-cal |
$2,362.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,502.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,350.00
|
| Rate for Payer: Multiplan Commercial |
$5,062.50
|
| Rate for Payer: Networks By Design Commercial |
$4,387.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,737.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,050.00
|
| Rate for Payer: Riverside University Health MISP |
$2,700.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,050.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,050.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,375.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,375.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,737.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5,737.50
|
|
|
HC COIL PENUMBRA
|
Facility
IP
|
$6,750.00
|
|
| Hospital Charge Code |
909020118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$6,075.00 |
| Rate for Payer: Cash Price |
$3,037.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,700.00
|
| Rate for Payer: Galaxy Health WC |
$5,737.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,050.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,075.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,502.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,350.00
|
| Rate for Payer: Multiplan Commercial |
$5,062.50
|
| Rate for Payer: Networks By Design Commercial |
$4,387.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,737.50
|
|
|
HC COIL PRESIDIO
|
Facility
OP
|
$6,375.00
|
|
| Hospital Charge Code |
909020099
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,275.00 |
| Max. Negotiated Rate |
$5,737.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,871.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,418.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,506.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,506.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,086.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,766.35
|
| Rate for Payer: BCBS Transplant Transplant |
$3,825.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,009.88
|
| Rate for Payer: Blue Shield of California EPN |
$3,117.38
|
| Rate for Payer: Cash Price |
$2,868.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,100.00
|
| Rate for Payer: Cigna of CA HMO |
$4,080.00
|
| Rate for Payer: Cigna of CA PPO |
$4,717.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,418.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,550.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,550.00
|
| Rate for Payer: Galaxy Health WC |
$5,418.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,825.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,737.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,781.25
|
| Rate for Payer: IEHP medi-cal |
$2,231.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,252.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.00
|
| Rate for Payer: Multiplan Commercial |
$4,781.25
|
| Rate for Payer: Networks By Design Commercial |
$4,143.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,418.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,825.00
|
| Rate for Payer: Riverside University Health MISP |
$2,550.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,825.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,825.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,187.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,187.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,187.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,187.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,418.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5,418.75
|
|
