|
HC RESECTION, PRTL OR CMPLT, PHLNGL BSE EA TOE
|
Facility
|
IP
|
$10,307.00
|
|
|
Service Code
|
CPT 28126
|
| Hospital Charge Code |
900566126
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,061.40 |
| Max. Negotiated Rate |
$9,276.30 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,214.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,122.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.80
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,544.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,081.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
|
|
HC RESECTION, PRTL OR CMPLT, PHLNGL BSE EA TOE
|
Facility
|
OP
|
$10,307.00
|
|
|
Service Code
|
CPT 28126
|
| Hospital Charge Code |
900566126
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$63.67 |
| Max. Negotiated Rate |
$9,276.30 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: Cigna of CA HMO |
$6,596.48
|
| Rate for Payer: Cigna of CA PPO |
$7,627.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,214.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,544.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,184.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,153.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,153.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,153.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,153.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
OP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| Rate for Payer: Adventist Health Commercial |
$46.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$196.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$127.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$173.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.78
|
| Rate for Payer: Blue Shield of California Commercial |
$146.90
|
| Rate for Payer: Blue Shield of California EPN |
$92.45
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Central Health Plan Commercial |
$185.36
|
| Rate for Payer: Cigna of CA HMO |
$148.29
|
| Rate for Payer: Cigna of CA PPO |
$171.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$196.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$196.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$196.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$162.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Senior |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$147.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$136.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$162.19
|
| Rate for Payer: Multiplan Commercial |
$173.78
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
| Rate for Payer: Riverside University Health System MISP |
$92.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.85
|
| Rate for Payer: United Healthcare All Other HMO |
$115.85
|
| Rate for Payer: United Healthcare HMO Rider |
$115.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$196.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$196.94
|
| Rate for Payer: Vantage Medical Group Senior |
$196.94
|
|
|
HC RESPIRATOR W/STRAP PEDS SZ 3
|
Facility
|
IP
|
$231.70
|
|
| Hospital Charge Code |
901698719
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| Rate for Payer: Adventist Health Commercial |
$46.34
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Central Health Plan Commercial |
$185.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$162.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Senior |
$92.68
|
| Rate for Payer: Galaxy Health WC |
$196.94
|
| Rate for Payer: Global Benefits Group Commercial |
$139.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$208.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$147.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$136.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.34
|
| Rate for Payer: Multiplan Commercial |
$173.78
|
| Rate for Payer: Networks By Design Commercial |
$150.60
|
| Rate for Payer: Prime Health Services Commercial |
$196.94
|
|
|
HC RESPIRATORY MINI PANEL
|
Facility
|
OP
|
$334.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$875.13 |
| Rate for Payer: Adventist Health Commercial |
$66.80
|
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$142.63
|
| Rate for Payer: Adventist Health Medi-Cal |
$142.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$875.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$875.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$324.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$324.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$450.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$450.55
|
| Rate for Payer: Blue Shield of California Commercial |
$246.96
|
| Rate for Payer: Blue Shield of California Commercial |
$210.42
|
| Rate for Payer: Blue Shield of California EPN |
$155.62
|
| Rate for Payer: Blue Shield of California EPN |
$132.60
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Cash Price |
$150.30
|
| Rate for Payer: Central Health Plan Commercial |
$267.20
|
| Rate for Payer: Central Health Plan Commercial |
$313.60
|
| Rate for Payer: Cigna of CA HMO |
$250.88
|
| Rate for Payer: Cigna of CA HMO |
$213.76
|
| Rate for Payer: Cigna of CA PPO |
$290.08
|
| Rate for Payer: Cigna of CA PPO |
$247.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$233.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: EPIC Health Plan Senior |
$156.89
|
| Rate for Payer: EPIC Health Plan Senior |
$156.89
|
| Rate for Payer: Galaxy Health WC |
$333.20
|
| Rate for Payer: Galaxy Health WC |
$283.90
|
| Rate for Payer: Global Benefits Group Commercial |
$235.20
|
| Rate for Payer: Global Benefits Group Commercial |
$200.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$352.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$300.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$233.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$233.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$245.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$245.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$142.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$142.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$212.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$248.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$199.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$199.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$191.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$191.12
|
| Rate for Payer: Multiplan Commercial |
$294.00
|
| Rate for Payer: Multiplan Commercial |
$250.50
|
| Rate for Payer: Networks By Design Commercial |
$217.10
|
| Rate for Payer: Networks By Design Commercial |
$254.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$142.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$142.63
|
| Rate for Payer: Prime Health Services Commercial |
$333.20
|
| Rate for Payer: Prime Health Services Commercial |
$283.90
|
| Rate for Payer: Prime Health Services Medicare |
$151.19
|
| Rate for Payer: Prime Health Services Medicare |
$151.19
|
| Rate for Payer: Riverside University Health System MISP |
$156.89
|
| Rate for Payer: Riverside University Health System MISP |
$156.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.53
|
| Rate for Payer: United Healthcare All Other HMO |
$115.53
|
| Rate for Payer: United Healthcare All Other HMO |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$142.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$142.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.89
|
| Rate for Payer: Vantage Medical Group Senior |
$142.63
|
| Rate for Payer: Vantage Medical Group Senior |
$142.63
|
|
|
HC RESPIRATORY MINI PANEL
|
Facility
|
IP
|
$392.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$352.80 |
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Central Health Plan Commercial |
$313.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Senior |
$156.80
|
| Rate for Payer: Galaxy Health WC |
$333.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$352.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$248.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$294.00
|
| Rate for Payer: Networks By Design Commercial |
$254.80
|
| Rate for Payer: Prime Health Services Commercial |
$333.20
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,386.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$3,336.82 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,400.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,400.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,336.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,336.82
|
| Rate for Payer: Blue Shield of California Commercial |
$292.32
|
| Rate for Payer: Blue Shield of California Commercial |
$970.20
|
| Rate for Payer: Blue Shield of California EPN |
$184.21
|
| Rate for Payer: Blue Shield of California EPN |
$611.38
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Central Health Plan Commercial |
$371.20
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$417.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$637.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$637.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$416.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$416.78
|
| Rate for Payer: Prime Health Services Commercial |
$394.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Medicare |
$441.79
|
| Rate for Payer: Prime Health Services Medicare |
$441.79
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP MGT STRENGTH&ENDURC-15MIN
|
Facility
|
IP
|
$328.00
|
|
|
Service Code
|
CPT G0237
|
| Hospital Charge Code |
900201802
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$295.20 |
| Rate for Payer: Adventist Health Commercial |
$65.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Central Health Plan Commercial |
$262.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$229.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$131.20
|
| Rate for Payer: EPIC Health Plan Senior |
$131.20
|
| Rate for Payer: Galaxy Health WC |
$278.80
|
| Rate for Payer: Global Benefits Group Commercial |
$196.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$295.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$208.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$193.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.60
|
| Rate for Payer: Multiplan Commercial |
$246.00
|
| Rate for Payer: Networks By Design Commercial |
$213.20
|
| Rate for Payer: Prime Health Services Commercial |
$278.80
|
|
|
HC RESP MGT STRENGTH&ENDURC-15MIN
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
CPT G0237
|
| Hospital Charge Code |
900201802
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$20.78 |
| Max. Negotiated Rate |
$536.00 |
| Rate for Payer: Adventist Health Commercial |
$65.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Central Health Plan Commercial |
$262.40
|
| Rate for Payer: Cigna of CA HMO |
$209.92
|
| Rate for Payer: Cigna of CA PPO |
$242.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$229.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.38
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$278.80
|
| Rate for Payer: Global Benefits Group Commercial |
$196.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$295.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$208.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$246.00
|
| Rate for Payer: Networks By Design Commercial |
$213.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.20
|
| Rate for Payer: Prime Health Services Commercial |
$278.80
|
| Rate for Payer: Prime Health Services Medicare |
$39.43
|
| Rate for Payer: Riverside University Health System MISP |
$40.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$502.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
OP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$3,336.82 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,400.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,400.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,336.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,336.82
|
| Rate for Payer: Blue Shield of California Commercial |
$292.32
|
| Rate for Payer: Blue Shield of California Commercial |
$970.20
|
| Rate for Payer: Blue Shield of California EPN |
$184.21
|
| Rate for Payer: Blue Shield of California EPN |
$611.38
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Central Health Plan Commercial |
$371.20
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA HMO |
$985.60
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Cigna of CA PPO |
$1,139.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$324.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$687.69
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: EPIC Health Plan Senior |
$458.46
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$417.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$637.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$637.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$294.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$416.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$416.78
|
| Rate for Payer: Prime Health Services Commercial |
$394.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
| Rate for Payer: Prime Health Services Medicare |
$441.79
|
| Rate for Payer: Prime Health Services Medicare |
$441.79
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$924.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$924.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare All Other HMO |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$416.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
IP
|
$1,540.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$1,386.00 |
| Rate for Payer: Adventist Health Commercial |
$308.00
|
| Rate for Payer: Cash Price |
$693.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,078.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.00
|
| Rate for Payer: EPIC Health Plan Senior |
$616.00
|
| Rate for Payer: Galaxy Health WC |
$1,309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$924.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$977.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$908.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$1,155.00
|
| Rate for Payer: Networks By Design Commercial |
$1,001.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.00
|
|
|
HC RESTING THALLIUM
|
Facility
|
IP
|
$2,853.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.60 |
| Max. Negotiated Rate |
$2,567.70 |
| Rate for Payer: Adventist Health Commercial |
$570.60
|
| Rate for Payer: Cash Price |
$1,283.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,282.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,997.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,141.20
|
| Rate for Payer: Galaxy Health WC |
$2,425.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,567.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,811.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,683.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.60
|
| Rate for Payer: Multiplan Commercial |
$2,139.75
|
| Rate for Payer: Networks By Design Commercial |
$1,854.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,425.05
|
|
|
HC RESTING THALLIUM
|
Facility
|
OP
|
$2,853.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$303.75 |
| Max. Negotiated Rate |
$2,747.46 |
| Rate for Payer: Adventist Health Commercial |
$570.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,665.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,556.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$812.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,659.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1,797.39
|
| Rate for Payer: Blue Shield of California EPN |
$1,132.64
|
| Rate for Payer: Cash Price |
$1,283.85
|
| Rate for Payer: Cash Price |
$1,283.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,282.40
|
| Rate for Payer: Cigna of CA HMO |
$1,825.92
|
| Rate for Payer: Cigna of CA PPO |
$2,111.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,997.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,747.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,831.64
|
| Rate for Payer: Galaxy Health WC |
$2,425.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,567.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,730.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$303.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,811.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$335.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,331.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,231.27
|
| Rate for Payer: Multiplan Commercial |
$2,139.75
|
| Rate for Payer: Networks By Design Commercial |
$1,854.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Prime Health Services Commercial |
$2,425.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,765.04
|
| Rate for Payer: Riverside University Health System MISP |
$1,831.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,711.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,665.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
IP
|
$86.74
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$78.07 |
| Rate for Payer: Adventist Health Commercial |
$17.35
|
| Rate for Payer: Cash Price |
$39.03
|
| Rate for Payer: Central Health Plan Commercial |
$69.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.70
|
| Rate for Payer: EPIC Health Plan Senior |
$34.70
|
| Rate for Payer: Galaxy Health WC |
$73.73
|
| Rate for Payer: Global Benefits Group Commercial |
$52.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$65.06
|
| Rate for Payer: Networks By Design Commercial |
$56.38
|
| Rate for Payer: Prime Health Services Commercial |
$73.73
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
OP
|
$86.74
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$78.07 |
| Rate for Payer: Adventist Health Commercial |
$17.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.46
|
| Rate for Payer: Blue Shield of California Commercial |
$54.99
|
| Rate for Payer: Blue Shield of California EPN |
$34.61
|
| Rate for Payer: Cash Price |
$39.03
|
| Rate for Payer: Central Health Plan Commercial |
$69.39
|
| Rate for Payer: Cigna of CA HMO |
$55.51
|
| Rate for Payer: Cigna of CA PPO |
$64.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.70
|
| Rate for Payer: EPIC Health Plan Senior |
$34.70
|
| Rate for Payer: Galaxy Health WC |
$73.73
|
| Rate for Payer: Global Benefits Group Commercial |
$52.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$60.72
|
| Rate for Payer: Multiplan Commercial |
$65.06
|
| Rate for Payer: Networks By Design Commercial |
$56.38
|
| Rate for Payer: Prime Health Services Commercial |
$73.73
|
| Rate for Payer: Riverside University Health System MISP |
$34.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.37
|
| Rate for Payer: United Healthcare All Other HMO |
$43.37
|
| Rate for Payer: United Healthcare HMO Rider |
$43.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.73
|
| Rate for Payer: Vantage Medical Group Senior |
$73.73
|
|
|
HC RESUSCITATOR MANUAL ADULT
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901605546
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901605546
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
OP
|
$82.16
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$73.94 |
| Rate for Payer: Adventist Health Commercial |
$16.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.79
|
| Rate for Payer: Blue Shield of California Commercial |
$52.09
|
| Rate for Payer: Blue Shield of California EPN |
$32.78
|
| Rate for Payer: Cash Price |
$36.97
|
| Rate for Payer: Central Health Plan Commercial |
$65.73
|
| Rate for Payer: Cigna of CA HMO |
$52.58
|
| Rate for Payer: Cigna of CA PPO |
$60.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.86
|
| Rate for Payer: EPIC Health Plan Senior |
$32.86
|
| Rate for Payer: Galaxy Health WC |
$69.84
|
| Rate for Payer: Global Benefits Group Commercial |
$49.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.51
|
| Rate for Payer: Multiplan Commercial |
$61.62
|
| Rate for Payer: Networks By Design Commercial |
$53.40
|
| Rate for Payer: Prime Health Services Commercial |
$69.84
|
| Rate for Payer: Riverside University Health System MISP |
$32.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.08
|
| Rate for Payer: United Healthcare All Other HMO |
$41.08
|
| Rate for Payer: United Healthcare HMO Rider |
$41.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.84
|
| Rate for Payer: Vantage Medical Group Senior |
$69.84
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
IP
|
$82.16
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.43 |
| Max. Negotiated Rate |
$73.94 |
| Rate for Payer: Adventist Health Commercial |
$16.43
|
| Rate for Payer: Cash Price |
$36.97
|
| Rate for Payer: Central Health Plan Commercial |
$65.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.86
|
| Rate for Payer: EPIC Health Plan Senior |
$32.86
|
| Rate for Payer: Galaxy Health WC |
$69.84
|
| Rate for Payer: Global Benefits Group Commercial |
$49.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.43
|
| Rate for Payer: Multiplan Commercial |
$61.62
|
| Rate for Payer: Networks By Design Commercial |
$53.40
|
| Rate for Payer: Prime Health Services Commercial |
$69.84
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
OP
|
$95.91
|
|
| Hospital Charge Code |
901607889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$86.32 |
| Rate for Payer: Adventist Health Commercial |
$19.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.79
|
| Rate for Payer: Blue Shield of California Commercial |
$60.81
|
| Rate for Payer: Blue Shield of California EPN |
$38.27
|
| Rate for Payer: Cash Price |
$43.16
|
| Rate for Payer: Central Health Plan Commercial |
$76.73
|
| Rate for Payer: Cigna of CA HMO |
$61.38
|
| Rate for Payer: Cigna of CA PPO |
$70.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.36
|
| Rate for Payer: EPIC Health Plan Senior |
$38.36
|
| Rate for Payer: Galaxy Health WC |
$81.52
|
| Rate for Payer: Global Benefits Group Commercial |
$57.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67.14
|
| Rate for Payer: Multiplan Commercial |
$71.93
|
| Rate for Payer: Networks By Design Commercial |
$62.34
|
| Rate for Payer: Prime Health Services Commercial |
$81.52
|
| Rate for Payer: Riverside University Health System MISP |
$38.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.95
|
| Rate for Payer: United Healthcare All Other HMO |
$47.95
|
| Rate for Payer: United Healthcare HMO Rider |
$47.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.52
|
| Rate for Payer: Vantage Medical Group Senior |
$81.52
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
IP
|
$95.91
|
|
| Hospital Charge Code |
901607889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$86.32 |
| Rate for Payer: Adventist Health Commercial |
$19.18
|
| Rate for Payer: Cash Price |
$43.16
|
| Rate for Payer: Central Health Plan Commercial |
$76.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.36
|
| Rate for Payer: EPIC Health Plan Senior |
$38.36
|
| Rate for Payer: Galaxy Health WC |
$81.52
|
| Rate for Payer: Global Benefits Group Commercial |
$57.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.18
|
| Rate for Payer: Multiplan Commercial |
$71.93
|
| Rate for Payer: Networks By Design Commercial |
$62.34
|
| Rate for Payer: Prime Health Services Commercial |
$81.52
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
OP
|
$110.66
|
|
| Hospital Charge Code |
901605545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$99.59 |
| Rate for Payer: Adventist Health Commercial |
$22.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.37
|
| Rate for Payer: Blue Shield of California Commercial |
$70.16
|
| Rate for Payer: Blue Shield of California EPN |
$44.15
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Central Health Plan Commercial |
$88.53
|
| Rate for Payer: Cigna of CA HMO |
$70.82
|
| Rate for Payer: Cigna of CA PPO |
$81.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.26
|
| Rate for Payer: EPIC Health Plan Senior |
$44.26
|
| Rate for Payer: Galaxy Health WC |
$94.06
|
| Rate for Payer: Global Benefits Group Commercial |
$66.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$77.46
|
| Rate for Payer: Multiplan Commercial |
$83.00
|
| Rate for Payer: Networks By Design Commercial |
$71.93
|
| Rate for Payer: Prime Health Services Commercial |
$94.06
|
| Rate for Payer: Riverside University Health System MISP |
$44.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.33
|
| Rate for Payer: United Healthcare All Other HMO |
$55.33
|
| Rate for Payer: United Healthcare HMO Rider |
$55.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.06
|
| Rate for Payer: Vantage Medical Group Senior |
$94.06
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
IP
|
$110.66
|
|
| Hospital Charge Code |
901605545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$99.59 |
| Rate for Payer: Adventist Health Commercial |
$22.13
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Central Health Plan Commercial |
$88.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.26
|
| Rate for Payer: EPIC Health Plan Senior |
$44.26
|
| Rate for Payer: Galaxy Health WC |
$94.06
|
| Rate for Payer: Global Benefits Group Commercial |
$66.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.13
|
| Rate for Payer: Multiplan Commercial |
$83.00
|
| Rate for Payer: Networks By Design Commercial |
$71.93
|
| Rate for Payer: Prime Health Services Commercial |
$94.06
|
|
|
HC RESUSCITATOR MANUAL PEDS
|
Facility
|
OP
|
$128.82
|
|
| Hospital Charge Code |
901605544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.76 |
| Max. Negotiated Rate |
$115.94 |
| Rate for Payer: Adventist Health Commercial |
$25.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$109.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.93
|
| Rate for Payer: Blue Shield of California Commercial |
$81.67
|
| Rate for Payer: Blue Shield of California EPN |
$51.40
|
| Rate for Payer: Cash Price |
$57.97
|
| Rate for Payer: Central Health Plan Commercial |
$103.06
|
| Rate for Payer: Cigna of CA HMO |
$82.44
|
| Rate for Payer: Cigna of CA PPO |
$95.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$109.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$109.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$90.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.53
|
| Rate for Payer: EPIC Health Plan Senior |
$51.53
|
| Rate for Payer: Galaxy Health WC |
$109.50
|
| Rate for Payer: Global Benefits Group Commercial |
$77.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$81.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$76.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$90.17
|
| Rate for Payer: Multiplan Commercial |
$96.61
|
| Rate for Payer: Networks By Design Commercial |
$83.73
|
| Rate for Payer: Prime Health Services Commercial |
$109.50
|
| Rate for Payer: Riverside University Health System MISP |
$51.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.41
|
| Rate for Payer: United Healthcare All Other HMO |
$64.41
|
| Rate for Payer: United Healthcare HMO Rider |
$64.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$109.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.50
|
| Rate for Payer: Vantage Medical Group Senior |
$109.50
|
|
