|
HC PICO SNGLE-USE NPWT 4IN X 12IN
|
Facility
|
IP
|
$1,213.25
|
|
| Hospital Charge Code |
901698264
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.65 |
| Max. Negotiated Rate |
$1,091.92 |
| Rate for Payer: Adventist Health Commercial |
$242.65
|
| Rate for Payer: Cash Price |
$545.96
|
| Rate for Payer: Central Health Plan Commercial |
$970.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$485.30
|
| Rate for Payer: EPIC Health Plan Senior |
$485.30
|
| Rate for Payer: Galaxy Health WC |
$1,031.26
|
| Rate for Payer: Global Benefits Group Commercial |
$727.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,091.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$809.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$751.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.65
|
| Rate for Payer: Multiplan Commercial |
$909.94
|
| Rate for Payer: Networks By Design Commercial |
$788.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,031.26
|
|
|
HC PICO SNGLE-USE NPWT 4IN X 16IN
|
Facility
|
OP
|
$1,213.25
|
|
| Hospital Charge Code |
901698265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.65 |
| Max. Negotiated Rate |
$1,091.92 |
| Rate for Payer: Adventist Health Commercial |
$242.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$736.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,031.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$667.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$909.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$587.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$712.54
|
| Rate for Payer: Blue Shield of California Commercial |
$741.30
|
| Rate for Payer: Blue Shield of California EPN |
$484.09
|
| Rate for Payer: Cash Price |
$545.96
|
| Rate for Payer: Central Health Plan Commercial |
$970.60
|
| Rate for Payer: Cigna of CA HMO |
$776.48
|
| Rate for Payer: Cigna of CA PPO |
$897.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,031.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,031.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$485.30
|
| Rate for Payer: EPIC Health Plan Senior |
$485.30
|
| Rate for Payer: Galaxy Health WC |
$1,031.26
|
| Rate for Payer: Global Benefits Group Commercial |
$727.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,091.92
|
| Rate for Payer: InnovAge PACE Commercial |
$606.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$809.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$751.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$849.27
|
| Rate for Payer: Multiplan Commercial |
$909.94
|
| Rate for Payer: Networks By Design Commercial |
$788.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,031.26
|
| Rate for Payer: Riverside University Health System MISP |
$485.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$727.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$727.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.62
|
| Rate for Payer: United Healthcare All Other HMO |
$606.62
|
| Rate for Payer: United Healthcare HMO Rider |
$606.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$606.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,031.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,031.26
|
|
|
HC PICO SNGLE-USE NPWT 4IN X 16IN
|
Facility
|
IP
|
$1,213.25
|
|
| Hospital Charge Code |
901698265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.65 |
| Max. Negotiated Rate |
$1,091.92 |
| Rate for Payer: Adventist Health Commercial |
$242.65
|
| Rate for Payer: Cash Price |
$545.96
|
| Rate for Payer: Central Health Plan Commercial |
$970.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$485.30
|
| Rate for Payer: EPIC Health Plan Senior |
$485.30
|
| Rate for Payer: Galaxy Health WC |
$1,031.26
|
| Rate for Payer: Global Benefits Group Commercial |
$727.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,091.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$809.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$751.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.65
|
| Rate for Payer: Multiplan Commercial |
$909.94
|
| Rate for Payer: Networks By Design Commercial |
$788.61
|
| Rate for Payer: Prime Health Services Commercial |
$1,031.26
|
|
|
HC PICO SNGLE-USE NPWT 6IN X 12IN
|
Facility
|
IP
|
$1,265.00
|
|
| Hospital Charge Code |
901698268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.00 |
| Max. Negotiated Rate |
$1,138.50 |
| Rate for Payer: Adventist Health Commercial |
$253.00
|
| Rate for Payer: Cash Price |
$569.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,012.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.00
|
| Rate for Payer: EPIC Health Plan Senior |
$506.00
|
| Rate for Payer: Galaxy Health WC |
$1,075.25
|
| Rate for Payer: Global Benefits Group Commercial |
$759.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,138.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$783.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.00
|
| Rate for Payer: Multiplan Commercial |
$948.75
|
| Rate for Payer: Networks By Design Commercial |
$822.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,075.25
|
|
|
HC PICO SNGLE-USE NPWT 6IN X 12IN
|
Facility
|
OP
|
$1,265.00
|
|
| Hospital Charge Code |
901698268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.00 |
| Max. Negotiated Rate |
$1,138.50 |
| Rate for Payer: Adventist Health Commercial |
$253.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$768.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,075.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$695.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$948.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$742.93
|
| Rate for Payer: Blue Shield of California Commercial |
$772.91
|
| Rate for Payer: Blue Shield of California EPN |
$504.74
|
| Rate for Payer: Cash Price |
$569.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,012.00
|
| Rate for Payer: Cigna of CA HMO |
$809.60
|
| Rate for Payer: Cigna of CA PPO |
$936.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,075.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,075.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,075.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.00
|
| Rate for Payer: EPIC Health Plan Senior |
$506.00
|
| Rate for Payer: Galaxy Health WC |
$1,075.25
|
| Rate for Payer: Global Benefits Group Commercial |
$759.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,138.50
|
| Rate for Payer: InnovAge PACE Commercial |
$632.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$783.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$885.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$885.50
|
| Rate for Payer: Multiplan Commercial |
$948.75
|
| Rate for Payer: Networks By Design Commercial |
$822.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,075.25
|
| Rate for Payer: Riverside University Health System MISP |
$506.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$759.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$759.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.50
|
| Rate for Payer: United Healthcare All Other HMO |
$632.50
|
| Rate for Payer: United Healthcare HMO Rider |
$632.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,075.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,075.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,075.25
|
|
|
HC PICU BACK TRANSPORT PER HOUR
|
Facility
|
IP
|
$3,506.00
|
|
| Hospital Charge Code |
905200103
|
|
Hospital Revenue Code
|
220
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$8,220.00 |
| Rate for Payer: Adventist Health Commercial |
$701.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$1,577.70
|
| Rate for Payer: Cash Price |
$1,577.70
|
| Rate for Payer: Cash Price |
$1,577.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,804.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,402.40
|
| Rate for Payer: Galaxy Health WC |
$2,980.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,155.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$215.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,338.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,335.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,170.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$701.20
|
| Rate for Payer: Multiplan Commercial |
$2,629.50
|
| Rate for Payer: Networks By Design Commercial |
$2,278.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,980.10
|
|
|
HC PICU TRANSPORT CASE RATE
|
Facility
|
IP
|
$2,021.00
|
|
| Hospital Charge Code |
905200104
|
|
Hospital Revenue Code
|
220
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$8,220.00 |
| Rate for Payer: Adventist Health Commercial |
$404.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$909.45
|
| Rate for Payer: Cash Price |
$909.45
|
| Rate for Payer: Cash Price |
$909.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,616.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$808.40
|
| Rate for Payer: EPIC Health Plan Senior |
$808.40
|
| Rate for Payer: Galaxy Health WC |
$1,717.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,212.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,818.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$215.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,348.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$770.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,251.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$404.20
|
| Rate for Payer: Multiplan Commercial |
$1,515.75
|
| Rate for Payer: Networks By Design Commercial |
$1,313.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,717.85
|
|
|
HC PICU TRANSPORT PER HOUR
|
Facility
|
IP
|
$2,918.00
|
|
| Hospital Charge Code |
905200100
|
|
Hospital Revenue Code
|
220
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$8,220.00 |
| Rate for Payer: Adventist Health Commercial |
$583.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,220.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,380.00
|
| Rate for Payer: Cash Price |
$1,313.10
|
| Rate for Payer: Cash Price |
$1,313.10
|
| Rate for Payer: Cash Price |
$1,313.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,334.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,167.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,167.20
|
| Rate for Payer: Galaxy Health WC |
$2,480.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,626.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$215.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,946.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,806.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.60
|
| Rate for Payer: Multiplan Commercial |
$2,188.50
|
| Rate for Payer: Networks By Design Commercial |
$1,896.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,480.30
|
|
|
HC PID
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.92
|
| Rate for Payer: Blue Shield of California Commercial |
$31.56
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: InnovAge PACE Commercial |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.08
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC PID
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900913005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
|
|
HC PI-LINKD AG, FLOW 1ST MRKR WBC
|
Facility
|
IP
|
$519.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
900914174
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$103.80 |
| Max. Negotiated Rate |
$467.10 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Cash Price |
$233.55
|
| Rate for Payer: Central Health Plan Commercial |
$415.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.60
|
| Rate for Payer: EPIC Health Plan Senior |
$207.60
|
| Rate for Payer: Galaxy Health WC |
$441.15
|
| Rate for Payer: Global Benefits Group Commercial |
$311.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$467.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$346.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$197.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$321.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.80
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
| Rate for Payer: Networks By Design Commercial |
$337.35
|
| Rate for Payer: Prime Health Services Commercial |
$441.15
|
|
|
HC PI-LINKD AG, FLOW 1ST MRKR WBC
|
Facility
|
OP
|
$519.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
900914174
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$57.59 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Adventist Health Commercial |
$103.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$457.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$315.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Shield of California Commercial |
$315.03
|
| Rate for Payer: Blue Shield of California EPN |
$206.04
|
| Rate for Payer: Cash Price |
$233.55
|
| Rate for Payer: Cash Price |
$233.55
|
| Rate for Payer: Central Health Plan Commercial |
$415.20
|
| Rate for Payer: Cigna of CA HMO |
$332.16
|
| Rate for Payer: Cigna of CA PPO |
$384.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$617.03
|
| Rate for Payer: EPIC Health Plan Senior |
$457.06
|
| Rate for Payer: Galaxy Health WC |
$441.15
|
| Rate for Payer: Global Benefits Group Commercial |
$311.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$467.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$749.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: InnovAge PACE Commercial |
$685.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$346.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$457.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$612.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$612.46
|
| Rate for Payer: Multiplan Commercial |
$389.25
|
| Rate for Payer: Networks By Design Commercial |
$337.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$457.06
|
| Rate for Payer: Prime Health Services Commercial |
$441.15
|
| Rate for Payer: Prime Health Services Medicare |
$484.48
|
| Rate for Payer: Riverside University Health System MISP |
$502.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$311.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$311.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$457.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
|
HC PI-LINKD AG,FLOW ADD'L MRKR,WBC
|
Facility
|
IP
|
$41.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
900914175
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
|
|
HC PI-LINKD AG,FLOW ADD'L MRKR,WBC
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
900914175
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$139.44 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.30
|
| Rate for Payer: Blue Shield of California Commercial |
$24.89
|
| Rate for Payer: Blue Shield of California EPN |
$16.28
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.57
|
| Rate for Payer: InnovAge PACE Commercial |
$20.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Riverside University Health System MISP |
$16.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.95
|
| Rate for Payer: United Healthcare All Other HMO |
$17.95
|
| Rate for Payer: United Healthcare HMO Rider |
$17.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34.85
|
|
|
HC PIN WORM PREP
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
900911636
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Central Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Senior |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC PIN WORM PREP
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
900911636
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.30
|
| Rate for Payer: Blue Shield of California Commercial |
$12.14
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4.27
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: InnovAge PACE Commercial |
$6.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.27
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Riverside University Health System MISP |
$4.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC PIPERACILLIN/TAZOBACTAM E TEST
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912422
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$16.41 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.33
|
| Rate for Payer: Blue Shield of California Commercial |
$10.93
|
| Rate for Payer: Blue Shield of California EPN |
$7.15
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC PIPERACILLIN/TAZOBACTAM E TEST
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912422
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
|
|
HC PIV ADULT IV START KIT
|
Facility
|
OP
|
$54.12
|
|
| Hospital Charge Code |
901698428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Adventist Health Commercial |
$10.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.78
|
| Rate for Payer: Blue Shield of California Commercial |
$33.07
|
| Rate for Payer: Blue Shield of California EPN |
$21.59
|
| Rate for Payer: Cash Price |
$24.35
|
| Rate for Payer: Central Health Plan Commercial |
$43.30
|
| Rate for Payer: Cigna of CA HMO |
$34.64
|
| Rate for Payer: Cigna of CA PPO |
$40.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$46.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Senior |
$21.65
|
| Rate for Payer: Galaxy Health WC |
$46.00
|
| Rate for Payer: Global Benefits Group Commercial |
$32.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.71
|
| Rate for Payer: InnovAge PACE Commercial |
$27.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.88
|
| Rate for Payer: Multiplan Commercial |
$40.59
|
| Rate for Payer: Networks By Design Commercial |
$35.18
|
| Rate for Payer: Prime Health Services Commercial |
$46.00
|
| Rate for Payer: Riverside University Health System MISP |
$21.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.06
|
| Rate for Payer: United Healthcare All Other HMO |
$27.06
|
| Rate for Payer: United Healthcare HMO Rider |
$27.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.00
|
| Rate for Payer: Vantage Medical Group Senior |
$46.00
|
|
|
HC PIV ADULT IV START KIT
|
Facility
|
IP
|
$54.12
|
|
| Hospital Charge Code |
901698428
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Adventist Health Commercial |
$10.82
|
| Rate for Payer: Cash Price |
$24.35
|
| Rate for Payer: Central Health Plan Commercial |
$43.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Senior |
$21.65
|
| Rate for Payer: Galaxy Health WC |
$46.00
|
| Rate for Payer: Global Benefits Group Commercial |
$32.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.82
|
| Rate for Payer: Multiplan Commercial |
$40.59
|
| Rate for Payer: Networks By Design Commercial |
$35.18
|
| Rate for Payer: Prime Health Services Commercial |
$46.00
|
|
|
HC PIV DRESSING CHANGE KIT
|
Facility
|
OP
|
$62.16
|
|
| Hospital Charge Code |
901698273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$55.94 |
| Rate for Payer: Adventist Health Commercial |
$12.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.51
|
| Rate for Payer: Blue Shield of California Commercial |
$37.98
|
| Rate for Payer: Blue Shield of California EPN |
$24.80
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Central Health Plan Commercial |
$49.73
|
| Rate for Payer: Cigna of CA HMO |
$39.78
|
| Rate for Payer: Cigna of CA PPO |
$46.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.86
|
| Rate for Payer: EPIC Health Plan Senior |
$24.86
|
| Rate for Payer: Galaxy Health WC |
$52.84
|
| Rate for Payer: Global Benefits Group Commercial |
$37.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.94
|
| Rate for Payer: InnovAge PACE Commercial |
$31.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.51
|
| Rate for Payer: Multiplan Commercial |
$46.62
|
| Rate for Payer: Networks By Design Commercial |
$40.40
|
| Rate for Payer: Prime Health Services Commercial |
$52.84
|
| Rate for Payer: Riverside University Health System MISP |
$24.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.08
|
| Rate for Payer: United Healthcare All Other HMO |
$31.08
|
| Rate for Payer: United Healthcare HMO Rider |
$31.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$52.84
|
|
|
HC PIV DRESSING CHANGE KIT
|
Facility
|
IP
|
$62.16
|
|
| Hospital Charge Code |
901698273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$55.94 |
| Rate for Payer: Adventist Health Commercial |
$12.43
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Central Health Plan Commercial |
$49.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.86
|
| Rate for Payer: EPIC Health Plan Senior |
$24.86
|
| Rate for Payer: Galaxy Health WC |
$52.84
|
| Rate for Payer: Global Benefits Group Commercial |
$37.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.43
|
| Rate for Payer: Multiplan Commercial |
$46.62
|
| Rate for Payer: Networks By Design Commercial |
$40.40
|
| Rate for Payer: Prime Health Services Commercial |
$52.84
|
|
|
HC PIV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
901698220
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$178.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.78
|
| Rate for Payer: Blue Shield of California Commercial |
$145.42
|
| Rate for Payer: Blue Shield of California EPN |
$94.96
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$202.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: InnovAge PACE Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$166.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Riverside University Health System MISP |
$95.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC PIV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
901698220
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
|
HC PIV KIT W/STNDR BORE EXT SET
|
Facility
|
IP
|
$22.06
|
|
| Hospital Charge Code |
901698435
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$19.85 |
| Rate for Payer: Adventist Health Commercial |
$4.41
|
| Rate for Payer: Cash Price |
$9.93
|
| Rate for Payer: Central Health Plan Commercial |
$17.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.82
|
| Rate for Payer: EPIC Health Plan Senior |
$8.82
|
| Rate for Payer: Galaxy Health WC |
$18.75
|
| Rate for Payer: Global Benefits Group Commercial |
$13.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.41
|
| Rate for Payer: Multiplan Commercial |
$16.55
|
| Rate for Payer: Networks By Design Commercial |
$14.34
|
| Rate for Payer: Prime Health Services Commercial |
$18.75
|
|
