|
HC ENDOTRACH 5.5MM W/CUFF PEDS
|
Facility
|
IP
|
$45.26
|
|
| Hospital Charge Code |
901698774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.94
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
|
|
HC ENDOTRACH 6.5MM W/CUFF ADULT
|
Facility
|
OP
|
$61.66
|
|
| Hospital Charge Code |
901698776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.43
|
| Rate for Payer: Blue Distinction Transplant |
$37.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38.78
|
| Rate for Payer: Blue Shield of California EPN |
$30.15
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Media |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Riverside University Health System MISP |
$24.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
|
HC ENDOTRACH 6.5MM W/CUFF ADULT
|
Facility
|
IP
|
$61.66
|
|
| Hospital Charge Code |
901698776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.49 |
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Central Health Plan Commercial |
$49.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.33
|
| Rate for Payer: Multiplan Commercial |
$46.24
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
IP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$585.80 |
| Max. Negotiated Rate |
$2,636.10 |
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,171.60
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
OP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,757.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,842.34
|
| Rate for Payer: Blue Shield of California EPN |
$1,432.28
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: Cigna of CA HMO |
$1,874.56
|
| Rate for Payer: Cigna of CA PPO |
$2,167.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,196.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$503.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,757.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,757.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,464.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,464.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,464.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,464.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
IP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$585.80 |
| Max. Negotiated Rate |
$2,636.10 |
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,171.60
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
OP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,757.40
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: Cigna of CA PPO |
$2,167.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,196.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,757.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,464.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,464.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,464.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,464.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
IP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$585.80 |
| Max. Negotiated Rate |
$2,636.10 |
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,171.60
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,115.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
|
|
HC ENDOTRACHEAL INTUBATION
|
Facility
|
OP
|
$2,929.00
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
900800115
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,757.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Cash Price |
$1,318.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,343.20
|
| Rate for Payer: Cigna of CA HMO |
$1,874.56
|
| Rate for Payer: Cigna of CA PPO |
$2,167.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$2,489.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,757.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,636.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,196.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$503.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,953.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$585.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$2,196.75
|
| Rate for Payer: Networks By Design Commercial |
$1,903.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,489.65
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,757.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,757.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC ENDOTRACH STYLET FLEXSLIP 14FR
|
Facility
|
IP
|
$15.91
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698673
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$14.32 |
| Rate for Payer: Cash Price |
$7.16
|
| Rate for Payer: Central Health Plan Commercial |
$12.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.36
|
| Rate for Payer: Galaxy Health WC |
$13.52
|
| Rate for Payer: Global Benefits Group Commercial |
$9.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.18
|
| Rate for Payer: Multiplan Commercial |
$11.93
|
| Rate for Payer: Networks By Design Commercial |
$10.34
|
| Rate for Payer: Prime Health Services Commercial |
$13.52
|
|
|
HC ENDOTRACH STYLET FLEXSLIP 14FR
|
Facility
|
OP
|
$15.91
|
|
|
Service Code
|
CPT A4212
|
| Hospital Charge Code |
901698673
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$16.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.40
|
| Rate for Payer: Blue Distinction Transplant |
$9.55
|
| Rate for Payer: Blue Shield of California Commercial |
$10.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.78
|
| Rate for Payer: Cash Price |
$7.16
|
| Rate for Payer: Cash Price |
$7.16
|
| Rate for Payer: Central Health Plan Commercial |
$12.73
|
| Rate for Payer: Cigna of CA HMO |
$10.18
|
| Rate for Payer: Cigna of CA PPO |
$11.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.52
|
| Rate for Payer: Dignity Health Media |
$13.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.36
|
| Rate for Payer: Galaxy Health WC |
$13.52
|
| Rate for Payer: Global Benefits Group Commercial |
$9.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.32
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.18
|
| Rate for Payer: Multiplan Commercial |
$11.93
|
| Rate for Payer: Networks By Design Commercial |
$10.34
|
| Rate for Payer: Prime Health Services Commercial |
$13.52
|
| Rate for Payer: Riverside University Health System MISP |
$6.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.96
|
| Rate for Payer: United Healthcare All Other HMO |
$7.96
|
| Rate for Payer: United Healthcare HMO Rider |
$7.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.52
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC ENDOTRACH TUBE INTRO 15FRX70CM
|
Facility
|
OP
|
$71.42
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$235.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$235.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.19
|
| Rate for Payer: Blue Distinction Transplant |
$42.85
|
| Rate for Payer: Blue Shield of California Commercial |
$44.92
|
| Rate for Payer: Blue Shield of California EPN |
$34.92
|
| Rate for Payer: Cash Price |
$32.14
|
| Rate for Payer: Cash Price |
$32.14
|
| Rate for Payer: Central Health Plan Commercial |
$57.14
|
| Rate for Payer: Cigna of CA HMO |
$45.71
|
| Rate for Payer: Cigna of CA PPO |
$52.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.71
|
| Rate for Payer: Dignity Health Media |
$60.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$28.57
|
| Rate for Payer: Galaxy Health WC |
$60.71
|
| Rate for Payer: Global Benefits Group Commercial |
$42.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.28
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$53.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
| Rate for Payer: Networks By Design Commercial |
$46.42
|
| Rate for Payer: Prime Health Services Commercial |
$60.71
|
| Rate for Payer: Riverside University Health System MISP |
$28.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.71
|
| Rate for Payer: United Healthcare All Other HMO |
$35.71
|
| Rate for Payer: United Healthcare HMO Rider |
$35.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.71
|
| Rate for Payer: Vantage Medical Group Senior |
$60.71
|
|
|
HC ENDOTRACH TUBE INTRO 15FRX70CM
|
Facility
|
IP
|
$71.42
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901698805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$64.28 |
| Rate for Payer: Cash Price |
$32.14
|
| Rate for Payer: Central Health Plan Commercial |
$57.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.57
|
| Rate for Payer: Galaxy Health WC |
$60.71
|
| Rate for Payer: Global Benefits Group Commercial |
$42.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
| Rate for Payer: Networks By Design Commercial |
$46.42
|
| Rate for Payer: Prime Health Services Commercial |
$60.71
|
|
|
HC ENDOTRACH VENTISEAL 5.5MM CUFF
|
Facility
|
OP
|
$30.34
|
|
| Hospital Charge Code |
901698780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.92
|
| Rate for Payer: Blue Distinction Transplant |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.84
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Media |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Riverside University Health System MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC ENDOTRACH VENTISEAL 5.5MM CUFF
|
Facility
|
IP
|
$30.34
|
|
| Hospital Charge Code |
901698780
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC ENDOTRACH VENTISEAL 6.5MM CUFF
|
Facility
|
IP
|
$30.34
|
|
| Hospital Charge Code |
901698787
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC ENDOTRACH VENTISEAL 6.5MM CUFF
|
Facility
|
OP
|
$30.34
|
|
| Hospital Charge Code |
901698787
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.92
|
| Rate for Payer: Blue Distinction Transplant |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.84
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Media |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Riverside University Health System MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC ENDOVASC TEMP VESSEL OCCLUSION
|
Facility
|
IP
|
$33,470.00
|
|
|
Service Code
|
CPT 61623
|
| Hospital Charge Code |
909081670
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$6,694.00 |
| Max. Negotiated Rate |
$30,123.00 |
| Rate for Payer: Cash Price |
$15,061.50
|
| Rate for Payer: Central Health Plan Commercial |
$26,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,388.00
|
| Rate for Payer: Galaxy Health WC |
$28,449.50
|
| Rate for Payer: Global Benefits Group Commercial |
$20,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,123.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,324.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,752.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,694.00
|
| Rate for Payer: Multiplan Commercial |
$25,102.50
|
| Rate for Payer: Networks By Design Commercial |
$21,755.50
|
| Rate for Payer: Prime Health Services Commercial |
$28,449.50
|
|
|
HC ENDOVASC TEMP VESSEL OCCLUSION
|
Facility
|
OP
|
$33,470.00
|
|
|
Service Code
|
CPT 61623
|
| Hospital Charge Code |
909081670
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$30,123.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,417.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$20,082.00
|
| Rate for Payer: Blue Shield of California Commercial |
$20,684.46
|
| Rate for Payer: Blue Shield of California EPN |
$16,266.42
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$15,061.50
|
| Rate for Payer: Cash Price |
$15,061.50
|
| Rate for Payer: Central Health Plan Commercial |
$26,776.00
|
| Rate for Payer: Cigna of CA HMO |
$21,420.80
|
| Rate for Payer: Cigna of CA PPO |
$24,767.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$28,449.50
|
| Rate for Payer: Global Benefits Group Commercial |
$20,082.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,123.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25,102.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,324.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,694.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$25,102.50
|
| Rate for Payer: Networks By Design Commercial |
$21,755.50
|
| Rate for Payer: Prime Health Services Commercial |
$28,449.50
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,082.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20,082.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,735.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,735.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,735.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ENOVENOUS ABLATION THERAPY
|
Facility
|
IP
|
$14,396.00
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
909080041
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,879.20 |
| Max. Negotiated Rate |
$12,956.40 |
| Rate for Payer: Cash Price |
$6,478.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,516.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,758.40
|
| Rate for Payer: Galaxy Health WC |
$12,236.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,637.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,956.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,602.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,484.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,879.20
|
| Rate for Payer: Multiplan Commercial |
$10,797.00
|
| Rate for Payer: Networks By Design Commercial |
$9,357.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,236.60
|
|
|
HC ENOVENOUS ABLATION THERAPY
|
Facility
|
OP
|
$14,396.00
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
909080041
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,879.20 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,637.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$6,478.20
|
| Rate for Payer: Cash Price |
$6,478.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,516.80
|
| Rate for Payer: Cigna of CA PPO |
$10,653.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$12,236.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,637.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,956.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,797.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,602.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,779.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,879.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$10,797.00
|
| Rate for Payer: Networks By Design Commercial |
$9,357.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,236.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,637.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ENTERCOLYSIS DBL CNTRST
|
Facility
|
IP
|
$1,401.00
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
909001852
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.20 |
| Max. Negotiated Rate |
$1,260.90 |
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.40
|
| Rate for Payer: Galaxy Health WC |
$1,190.85
|
| Rate for Payer: Global Benefits Group Commercial |
$840.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$934.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.20
|
| Rate for Payer: Multiplan Commercial |
$1,050.75
|
| Rate for Payer: Networks By Design Commercial |
$910.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.85
|
|
|
HC ENTERCOLYSIS DBL CNTRST
|
Facility
|
OP
|
$1,401.00
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
909001852
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.56 |
| Max. Negotiated Rate |
$1,260.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$229.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$796.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$273.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$333.05
|
| Rate for Payer: Blue Distinction Transplant |
$840.60
|
| Rate for Payer: Blue Shield of California Commercial |
$865.82
|
| Rate for Payer: Blue Shield of California EPN |
$680.89
|
| Rate for Payer: Caremore Medicare Advantage |
$229.56
|
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: Cash Price |
$630.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.80
|
| Rate for Payer: Cigna of CA HMO |
$896.64
|
| Rate for Payer: Cigna of CA PPO |
$1,036.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$1,190.85
|
| Rate for Payer: Global Benefits Group Commercial |
$840.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,050.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$378.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: InnovAge PACE Commercial |
$344.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$934.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$691.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$307.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$1,050.75
|
| Rate for Payer: Networks By Design Commercial |
$910.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.85
|
| Rate for Payer: Prime Health Services Medicare |
$243.33
|
| Rate for Payer: Riverside University Health System MISP |
$252.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$840.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$840.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$364.06
|
| Rate for Payer: United Healthcare All Other HMO |
$364.06
|
| Rate for Payer: United Healthcare HMO Rider |
$364.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$364.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC EO DBL UPRIGHT ADJ POS LOCK
|
Facility
|
IP
|
$2,892.00
|
|
|
Service Code
|
CPT L3740
|
| Hospital Charge Code |
905353740
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$578.40 |
| Max. Negotiated Rate |
$2,602.80 |
| Rate for Payer: Blue Shield of California EPN |
$1,544.33
|
| Rate for Payer: Cash Price |
$1,301.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,313.60
|
| Rate for Payer: Cigna of CA HMO |
$2,024.40
|
| Rate for Payer: Cigna of CA PPO |
$2,024.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,156.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,156.80
|
| Rate for Payer: Galaxy Health WC |
$2,458.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,735.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,602.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,928.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,101.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$578.40
|
| Rate for Payer: Multiplan Commercial |
$2,169.00
|
| Rate for Payer: Networks By Design Commercial |
$1,446.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,458.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,092.02
|
| Rate for Payer: United Healthcare All Other HMO |
$1,066.57
|
| Rate for Payer: United Healthcare HMO Rider |
$1,043.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$954.36
|
|
|
HC EO DBL UPRIGHT ADJ POS LOCK
|
Facility
|
OP
|
$2,892.00
|
|
|
Service Code
|
CPT L3740
|
| Hospital Charge Code |
905353740
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,012.20 |
| Max. Negotiated Rate |
$2,602.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,458.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,590.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,590.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,400.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,708.59
|
| Rate for Payer: Blue Distinction Transplant |
$1,735.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,169.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,573.25
|
| Rate for Payer: Cash Price |
$1,301.40
|
| Rate for Payer: Cash Price |
$1,301.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,313.60
|
| Rate for Payer: Cigna of CA HMO |
$2,024.40
|
| Rate for Payer: Cigna of CA PPO |
$2,024.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,458.20
|
| Rate for Payer: Dignity Health Media |
$2,458.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,458.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,156.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,156.80
|
| Rate for Payer: Galaxy Health WC |
$2,458.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,735.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,602.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,169.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,012.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,928.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,600.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,185.72
|
| Rate for Payer: Multiplan Commercial |
$2,169.00
|
| Rate for Payer: Networks By Design Commercial |
$1,446.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,458.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,156.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,735.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,735.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,446.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,446.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,446.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,446.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,458.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,458.20
|
|
