|
HC DRAIN LUMBAR LIMITORR 30ML
|
Facility
|
OP
|
$1,213.20
|
|
| Hospital Charge Code |
901698150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.64 |
| Max. Negotiated Rate |
$1,091.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$736.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,031.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$667.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$667.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$587.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$716.76
|
| Rate for Payer: Blue Distinction Transplant |
$727.92
|
| Rate for Payer: Blue Shield of California Commercial |
$763.10
|
| Rate for Payer: Blue Shield of California EPN |
$593.25
|
| Rate for Payer: Cash Price |
$545.94
|
| Rate for Payer: Central Health Plan Commercial |
$970.56
|
| Rate for Payer: Cigna of CA HMO |
$776.45
|
| Rate for Payer: Cigna of CA PPO |
$897.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.22
|
| Rate for Payer: Dignity Health Media |
$1,031.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,031.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$485.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$485.28
|
| Rate for Payer: Galaxy Health WC |
$1,031.22
|
| Rate for Payer: Global Benefits Group Commercial |
$727.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,091.88
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$909.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$424.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$809.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.64
|
| Rate for Payer: Multiplan Commercial |
$909.90
|
| Rate for Payer: Networks By Design Commercial |
$788.58
|
| Rate for Payer: Prime Health Services Commercial |
$1,031.22
|
| Rate for Payer: Riverside University Health System MISP |
$485.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$727.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$727.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.60
|
| Rate for Payer: United Healthcare All Other HMO |
$606.60
|
| Rate for Payer: United Healthcare HMO Rider |
$606.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$606.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,031.22
|
| Rate for Payer: Vantage Medical Group Senior |
$1,031.22
|
|
|
HC DRAIN LUMBAR LIMITORR 30ML
|
Facility
|
IP
|
$1,213.20
|
|
| Hospital Charge Code |
901698150
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.64 |
| Max. Negotiated Rate |
$1,091.88 |
| Rate for Payer: Cash Price |
$545.94
|
| Rate for Payer: Central Health Plan Commercial |
$970.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$485.28
|
| Rate for Payer: Galaxy Health WC |
$1,031.22
|
| Rate for Payer: Global Benefits Group Commercial |
$727.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,091.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$809.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.64
|
| Rate for Payer: Multiplan Commercial |
$909.90
|
| Rate for Payer: Networks By Design Commercial |
$788.58
|
| Rate for Payer: Prime Health Services Commercial |
$1,031.22
|
|
|
HC DRAIN PENROSE 12X1/2" STD STRL
|
Facility
|
OP
|
$9.27
|
|
| Hospital Charge Code |
901698440
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$8.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.48
|
| Rate for Payer: Blue Distinction Transplant |
$5.56
|
| Rate for Payer: Blue Shield of California Commercial |
$5.83
|
| Rate for Payer: Blue Shield of California EPN |
$4.53
|
| Rate for Payer: Cash Price |
$4.17
|
| Rate for Payer: Central Health Plan Commercial |
$7.42
|
| Rate for Payer: Cigna of CA HMO |
$5.93
|
| Rate for Payer: Cigna of CA PPO |
$6.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.88
|
| Rate for Payer: Dignity Health Media |
$7.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.71
|
| Rate for Payer: Galaxy Health WC |
$7.88
|
| Rate for Payer: Global Benefits Group Commercial |
$5.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.85
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
| Rate for Payer: Networks By Design Commercial |
$6.03
|
| Rate for Payer: Prime Health Services Commercial |
$7.88
|
| Rate for Payer: Riverside University Health System MISP |
$3.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.64
|
| Rate for Payer: United Healthcare All Other HMO |
$4.64
|
| Rate for Payer: United Healthcare HMO Rider |
$4.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.88
|
| Rate for Payer: Vantage Medical Group Senior |
$7.88
|
|
|
HC DRAIN PENROSE 12X1/2" STD STRL
|
Facility
|
IP
|
$9.27
|
|
| Hospital Charge Code |
901698440
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$8.34 |
| Rate for Payer: Cash Price |
$4.17
|
| Rate for Payer: Central Health Plan Commercial |
$7.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: Galaxy Health WC |
$7.88
|
| Rate for Payer: Global Benefits Group Commercial |
$5.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.85
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
| Rate for Payer: Networks By Design Commercial |
$6.03
|
| Rate for Payer: Prime Health Services Commercial |
$7.88
|
|
|
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: 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 |
$5.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.57
|
| Rate for Payer: Blue Distinction Transplant |
$5.66
|
| Rate for Payer: Blue Shield of California Commercial |
$5.93
|
| Rate for Payer: Blue Shield of California EPN |
$4.61
|
| Rate for Payer: Cash Price |
$4.24
|
| 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 Media |
$8.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$7.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| 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: LLUH Dept of Risk Management WC |
$1.89
|
| 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 |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC DRAIN PENROSE 1/2 X 12" STERL
|
Facility
|
IP
|
$9.43
|
|
| Hospital Charge Code |
901601235
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: Central Health Plan Commercial |
$7.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Kaiser Permanente of CA Commercial/Self Funded |
$6.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.89
|
| 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
|
|
|
HC DRAIN PENROSE 12 X 1/4" STERL
|
Facility
|
OP
|
$6.64
|
|
| Hospital Charge Code |
901698436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.92
|
| Rate for Payer: Blue Distinction Transplant |
$3.98
|
| Rate for Payer: Blue Shield of California Commercial |
$4.18
|
| Rate for Payer: Blue Shield of California EPN |
$3.25
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Central Health Plan Commercial |
$5.31
|
| Rate for Payer: Cigna of CA HMO |
$4.25
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.64
|
| Rate for Payer: Dignity Health Media |
$5.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.98
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.33
|
| Rate for Payer: Multiplan Commercial |
$4.98
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
| Rate for Payer: Riverside University Health System MISP |
$2.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.32
|
| Rate for Payer: United Healthcare All Other HMO |
$3.32
|
| Rate for Payer: United Healthcare HMO Rider |
$3.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.64
|
| Rate for Payer: Vantage Medical Group Senior |
$5.64
|
|
|
HC DRAIN PENROSE 12 X 1/4" STERL
|
Facility
|
IP
|
$6.64
|
|
| Hospital Charge Code |
901698436
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.98 |
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Central Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.33
|
| Rate for Payer: Multiplan Commercial |
$4.98
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
|
|
HC DRAIN PENROSE 13MM FLAT STRL
|
Facility
|
IP
|
$6.81
|
|
| Hospital Charge Code |
901698431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Central Health Plan Commercial |
$5.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.72
|
| Rate for Payer: Galaxy Health WC |
$5.79
|
| Rate for Payer: Global Benefits Group Commercial |
$4.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$5.11
|
| Rate for Payer: Networks By Design Commercial |
$4.43
|
| Rate for Payer: Prime Health Services Commercial |
$5.79
|
|
|
HC DRAIN PENROSE 13MM FLAT STRL
|
Facility
|
OP
|
$6.81
|
|
| Hospital Charge Code |
901698431
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.02
|
| Rate for Payer: Blue Distinction Transplant |
$4.09
|
| Rate for Payer: Blue Shield of California Commercial |
$4.28
|
| Rate for Payer: Blue Shield of California EPN |
$3.33
|
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Central Health Plan Commercial |
$5.45
|
| Rate for Payer: Cigna of CA HMO |
$4.36
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.79
|
| Rate for Payer: Dignity Health Media |
$5.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.72
|
| Rate for Payer: Galaxy Health WC |
$5.79
|
| Rate for Payer: Global Benefits Group Commercial |
$4.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.13
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$5.11
|
| Rate for Payer: Networks By Design Commercial |
$4.43
|
| Rate for Payer: Prime Health Services Commercial |
$5.79
|
| Rate for Payer: Riverside University Health System MISP |
$2.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.40
|
| Rate for Payer: United Healthcare All Other HMO |
$3.40
|
| Rate for Payer: United Healthcare HMO Rider |
$3.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.79
|
| Rate for Payer: Vantage Medical Group Senior |
$5.79
|
|
|
HC DRAIN PENROSE 1/4 X 12" STERL
|
Facility
|
OP
|
$9.43
|
|
| Hospital Charge Code |
901601234
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$8.49 |
| 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 |
$5.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.57
|
| Rate for Payer: Blue Distinction Transplant |
$5.66
|
| Rate for Payer: Blue Shield of California Commercial |
$5.93
|
| Rate for Payer: Blue Shield of California EPN |
$4.61
|
| Rate for Payer: Cash Price |
$4.24
|
| 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 Media |
$8.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$7.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| 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: LLUH Dept of Risk Management WC |
$1.89
|
| 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 |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC DRAIN PENROSE 1/4 X 12" STERL
|
Facility
|
IP
|
$9.43
|
|
| Hospital Charge Code |
901601234
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: Central Health Plan Commercial |
$7.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: Kaiser Permanente of CA Commercial/Self Funded |
$6.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.89
|
| 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
|
|
|
HC DRAIN PENROSE 1/4X18 STERILE
|
Facility
|
IP
|
$6.07
|
|
| Hospital Charge Code |
901601838
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$5.46 |
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Central Health Plan Commercial |
$4.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.43
|
| Rate for Payer: Galaxy Health WC |
$5.16
|
| Rate for Payer: Global Benefits Group Commercial |
$3.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.21
|
| Rate for Payer: Multiplan Commercial |
$4.55
|
| Rate for Payer: Networks By Design Commercial |
$3.95
|
| Rate for Payer: Prime Health Services Commercial |
$5.16
|
|
|
HC DRAIN PENROSE 1/4X18 STERILE
|
Facility
|
OP
|
$6.07
|
|
| Hospital Charge Code |
901601838
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$5.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.59
|
| Rate for Payer: Blue Distinction Transplant |
$3.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3.82
|
| Rate for Payer: Blue Shield of California EPN |
$2.97
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Central Health Plan Commercial |
$4.86
|
| Rate for Payer: Cigna of CA HMO |
$3.88
|
| Rate for Payer: Cigna of CA PPO |
$4.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.16
|
| Rate for Payer: Dignity Health Media |
$5.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.43
|
| Rate for Payer: Galaxy Health WC |
$5.16
|
| Rate for Payer: Global Benefits Group Commercial |
$3.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.21
|
| Rate for Payer: Multiplan Commercial |
$4.55
|
| Rate for Payer: Networks By Design Commercial |
$3.95
|
| Rate for Payer: Prime Health Services Commercial |
$5.16
|
| Rate for Payer: Riverside University Health System MISP |
$2.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.04
|
| Rate for Payer: United Healthcare All Other HMO |
$3.04
|
| Rate for Payer: United Healthcare HMO Rider |
$3.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.16
|
| Rate for Payer: Vantage Medical Group Senior |
$5.16
|
|
|
HC DRAIN PENROSE 1/4X18" STERILE
|
Facility
|
OP
|
$13.45
|
|
| Hospital Charge Code |
901698421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.95
|
| Rate for Payer: Blue Distinction Transplant |
$8.07
|
| Rate for Payer: Blue Shield of California Commercial |
$8.46
|
| Rate for Payer: Blue Shield of California EPN |
$6.58
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: Cigna of CA HMO |
$8.61
|
| Rate for Payer: Cigna of CA PPO |
$9.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.43
|
| Rate for Payer: Dignity Health Media |
$11.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.72
|
| Rate for Payer: United Healthcare All Other HMO |
$6.72
|
| Rate for Payer: United Healthcare HMO Rider |
$6.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC DRAIN PENROSE 1/4X18" STERILE
|
Facility
|
IP
|
$13.45
|
|
| Hospital Charge Code |
901698421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.10 |
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
|
|
HC DRAIN PENROSE 1 X 12" STERILE
|
Facility
|
OP
|
$5.82
|
|
| Hospital Charge Code |
901601237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$5.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.44
|
| Rate for Payer: Blue Distinction Transplant |
$3.49
|
| Rate for Payer: Blue Shield of California Commercial |
$3.66
|
| Rate for Payer: Blue Shield of California EPN |
$2.85
|
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Central Health Plan Commercial |
$4.66
|
| Rate for Payer: Cigna of CA HMO |
$3.72
|
| Rate for Payer: Cigna of CA PPO |
$4.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.95
|
| Rate for Payer: Dignity Health Media |
$4.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.33
|
| Rate for Payer: Galaxy Health WC |
$4.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.24
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.16
|
| Rate for Payer: Multiplan Commercial |
$4.36
|
| Rate for Payer: Networks By Design Commercial |
$3.78
|
| Rate for Payer: Prime Health Services Commercial |
$4.95
|
| Rate for Payer: Riverside University Health System MISP |
$2.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.91
|
| Rate for Payer: United Healthcare All Other HMO |
$2.91
|
| Rate for Payer: United Healthcare HMO Rider |
$2.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.95
|
| Rate for Payer: Vantage Medical Group Senior |
$4.95
|
|
|
HC DRAIN PENROSE 1 X 12" STERILE
|
Facility
|
IP
|
$5.82
|
|
| Hospital Charge Code |
901601237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$5.24 |
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Central Health Plan Commercial |
$4.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.33
|
| Rate for Payer: Galaxy Health WC |
$4.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.16
|
| Rate for Payer: Multiplan Commercial |
$4.36
|
| Rate for Payer: Networks By Design Commercial |
$3.78
|
| Rate for Payer: Prime Health Services Commercial |
$4.95
|
|
|
HC DRAIN PENROSE .25X18IN STRL
|
Facility
|
OP
|
$7.63
|
|
| Hospital Charge Code |
901698467
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.51
|
| Rate for Payer: Blue Distinction Transplant |
$4.58
|
| Rate for Payer: Blue Shield of California Commercial |
$4.80
|
| Rate for Payer: Blue Shield of California EPN |
$3.73
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: Cigna of CA HMO |
$4.88
|
| Rate for Payer: Cigna of CA PPO |
$5.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.49
|
| Rate for Payer: Dignity Health Media |
$6.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
| Rate for Payer: Riverside University Health System MISP |
$3.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.82
|
| Rate for Payer: United Healthcare All Other HMO |
$3.82
|
| Rate for Payer: United Healthcare HMO Rider |
$3.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.49
|
| Rate for Payer: Vantage Medical Group Senior |
$6.49
|
|
|
HC DRAIN PENROSE .25X18IN STRL
|
Facility
|
IP
|
$7.63
|
|
| Hospital Charge Code |
901698467
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Central Health Plan Commercial |
$6.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.05
|
| Rate for Payer: Galaxy Health WC |
$6.49
|
| Rate for Payer: Global Benefits Group Commercial |
$4.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.53
|
| Rate for Payer: Multiplan Commercial |
$5.72
|
| Rate for Payer: Networks By Design Commercial |
$4.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.49
|
|
|
HC DRAIN PENROSE 6MM FLAT STRL
|
Facility
|
OP
|
$6.81
|
|
| Hospital Charge Code |
901698430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.02
|
| Rate for Payer: Blue Distinction Transplant |
$4.09
|
| Rate for Payer: Blue Shield of California Commercial |
$4.28
|
| Rate for Payer: Blue Shield of California EPN |
$3.33
|
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Central Health Plan Commercial |
$5.45
|
| Rate for Payer: Cigna of CA HMO |
$4.36
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.79
|
| Rate for Payer: Dignity Health Media |
$5.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.72
|
| Rate for Payer: Galaxy Health WC |
$5.79
|
| Rate for Payer: Global Benefits Group Commercial |
$4.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.13
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$5.11
|
| Rate for Payer: Networks By Design Commercial |
$4.43
|
| Rate for Payer: Prime Health Services Commercial |
$5.79
|
| Rate for Payer: Riverside University Health System MISP |
$2.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.40
|
| Rate for Payer: United Healthcare All Other HMO |
$3.40
|
| Rate for Payer: United Healthcare HMO Rider |
$3.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.79
|
| Rate for Payer: Vantage Medical Group Senior |
$5.79
|
|
|
HC DRAIN PENROSE 6MM FLAT STRL
|
Facility
|
IP
|
$6.81
|
|
| Hospital Charge Code |
901698430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$6.13 |
| Rate for Payer: Cash Price |
$3.06
|
| Rate for Payer: Central Health Plan Commercial |
$5.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.72
|
| Rate for Payer: Galaxy Health WC |
$5.79
|
| Rate for Payer: Global Benefits Group Commercial |
$4.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$5.11
|
| Rate for Payer: Networks By Design Commercial |
$4.43
|
| Rate for Payer: Prime Health Services Commercial |
$5.79
|
|
|
HC DRAIN PLEUREX 1000ML
|
Facility
|
IP
|
$457.21
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901605687
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.44 |
| Max. Negotiated Rate |
$411.49 |
| Rate for Payer: Cash Price |
$205.74
|
| Rate for Payer: Central Health Plan Commercial |
$365.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.88
|
| Rate for Payer: Galaxy Health WC |
$388.63
|
| Rate for Payer: Global Benefits Group Commercial |
$274.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.44
|
| Rate for Payer: Multiplan Commercial |
$342.91
|
| Rate for Payer: Networks By Design Commercial |
$297.19
|
| Rate for Payer: Prime Health Services Commercial |
$388.63
|
|
|
HC DRAIN PLEUREX 1000ML
|
Facility
|
OP
|
$457.21
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901605687
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.44 |
| Max. Negotiated Rate |
$411.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$388.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$251.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$251.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$221.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$270.12
|
| Rate for Payer: Blue Distinction Transplant |
$274.33
|
| Rate for Payer: Blue Shield of California Commercial |
$287.59
|
| Rate for Payer: Blue Shield of California EPN |
$223.58
|
| Rate for Payer: Cash Price |
$205.74
|
| Rate for Payer: Cash Price |
$205.74
|
| Rate for Payer: Central Health Plan Commercial |
$365.77
|
| Rate for Payer: Cigna of CA HMO |
$292.61
|
| Rate for Payer: Cigna of CA PPO |
$338.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$388.63
|
| Rate for Payer: Dignity Health Media |
$388.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$388.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$182.88
|
| Rate for Payer: Galaxy Health WC |
$388.63
|
| Rate for Payer: Global Benefits Group Commercial |
$274.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$342.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$160.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.44
|
| Rate for Payer: Multiplan Commercial |
$342.91
|
| Rate for Payer: Networks By Design Commercial |
$297.19
|
| Rate for Payer: Prime Health Services Commercial |
$388.63
|
| Rate for Payer: Riverside University Health System MISP |
$182.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.60
|
| Rate for Payer: United Healthcare All Other HMO |
$228.60
|
| Rate for Payer: United Healthcare HMO Rider |
$228.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$388.63
|
| Rate for Payer: Vantage Medical Group Senior |
$388.63
|
|
|
HC DRAIN PVC 1/8" CONSTAVAC
|
Facility
|
OP
|
$63.96
|
|
| Hospital Charge Code |
901602283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$57.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.79
|
| Rate for Payer: Blue Distinction Transplant |
$38.38
|
| Rate for Payer: Blue Shield of California Commercial |
$40.23
|
| Rate for Payer: Blue Shield of California EPN |
$31.28
|
| Rate for Payer: Cash Price |
$28.78
|
| Rate for Payer: Central Health Plan Commercial |
$51.17
|
| Rate for Payer: Cigna of CA HMO |
$40.93
|
| Rate for Payer: Cigna of CA PPO |
$47.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.37
|
| Rate for Payer: Dignity Health Media |
$54.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.58
|
| Rate for Payer: Galaxy Health WC |
$54.37
|
| Rate for Payer: Global Benefits Group Commercial |
$38.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$47.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.79
|
| Rate for Payer: Multiplan Commercial |
$47.97
|
| Rate for Payer: Networks By Design Commercial |
$41.57
|
| Rate for Payer: Prime Health Services Commercial |
$54.37
|
| Rate for Payer: Riverside University Health System MISP |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.98
|
| Rate for Payer: United Healthcare All Other HMO |
$31.98
|
| Rate for Payer: United Healthcare HMO Rider |
$31.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.37
|
| Rate for Payer: Vantage Medical Group Senior |
$54.37
|
|
