|
HC RESEARCH IV HEPARIN LOCK PLACEMENT/BLOOD DRAW ESTAB PORT
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
900100027
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC RESEARCH OBSERVATION 1-4 HOURS
|
Facility
|
IP
|
$466.00
|
|
| Hospital Charge Code |
900100025
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$419.40 |
| Rate for Payer: Adventist Health Commercial |
$93.20
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Central Health Plan Commercial |
$372.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Senior |
$186.40
|
| Rate for Payer: Galaxy Health WC |
$396.10
|
| Rate for Payer: Global Benefits Group Commercial |
$279.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$419.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$310.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$288.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.20
|
| Rate for Payer: Multiplan Commercial |
$349.50
|
| Rate for Payer: Networks By Design Commercial |
$302.90
|
| Rate for Payer: Prime Health Services Commercial |
$396.10
|
|
|
HC RESEARCH OBSERVATION 1-4 HOURS
|
Facility
|
OP
|
$466.00
|
|
| Hospital Charge Code |
900100025
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$2,789.00 |
| Rate for Payer: Adventist Health Commercial |
$93.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$283.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$396.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$256.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$349.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,981.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,789.00
|
| Rate for Payer: Blue Shield of California Commercial |
$284.73
|
| Rate for Payer: Blue Shield of California EPN |
$185.93
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Central Health Plan Commercial |
$372.80
|
| Rate for Payer: Cigna of CA HMO |
$298.24
|
| Rate for Payer: Cigna of CA PPO |
$344.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$396.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$396.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$396.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Senior |
$186.40
|
| Rate for Payer: Galaxy Health WC |
$396.10
|
| Rate for Payer: Global Benefits Group Commercial |
$279.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$419.40
|
| Rate for Payer: InnovAge PACE Commercial |
$233.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$310.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$288.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$326.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$326.20
|
| Rate for Payer: Multiplan Commercial |
$349.50
|
| Rate for Payer: Networks By Design Commercial |
$302.90
|
| Rate for Payer: Prime Health Services Commercial |
$396.10
|
| Rate for Payer: Riverside University Health System MISP |
$186.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$279.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$279.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$233.00
|
| Rate for Payer: United Healthcare HMO Rider |
$233.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$233.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$396.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$396.10
|
| Rate for Payer: Vantage Medical Group Senior |
$396.10
|
|
|
HC RESEARCH OBSERVATION 4-8 HOURS
|
Facility
|
IP
|
$934.00
|
|
| Hospital Charge Code |
900100026
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$186.80 |
| Max. Negotiated Rate |
$840.60 |
| Rate for Payer: Adventist Health Commercial |
$186.80
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Central Health Plan Commercial |
$747.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: EPIC Health Plan Senior |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$578.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.80
|
| Rate for Payer: Multiplan Commercial |
$700.50
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
|
|
HC RESEARCH OBSERVATION 4-8 HOURS
|
Facility
|
OP
|
$934.00
|
|
| Hospital Charge Code |
900100026
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$186.80 |
| Max. Negotiated Rate |
$2,789.00 |
| Rate for Payer: Adventist Health Commercial |
$186.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$567.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$793.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$513.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$700.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,981.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,789.00
|
| Rate for Payer: Blue Shield of California Commercial |
$570.67
|
| Rate for Payer: Blue Shield of California EPN |
$372.67
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Central Health Plan Commercial |
$747.20
|
| Rate for Payer: Cigna of CA HMO |
$597.76
|
| Rate for Payer: Cigna of CA PPO |
$691.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$793.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$793.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$793.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: EPIC Health Plan Senior |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.60
|
| Rate for Payer: InnovAge PACE Commercial |
$467.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$578.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$653.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$653.80
|
| Rate for Payer: Multiplan Commercial |
$700.50
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
| Rate for Payer: Riverside University Health System MISP |
$373.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$560.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$560.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.00
|
| Rate for Payer: United Healthcare All Other HMO |
$467.00
|
| Rate for Payer: United Healthcare HMO Rider |
$467.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$467.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$793.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$793.90
|
| Rate for Payer: Vantage Medical Group Senior |
$793.90
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
OP
|
$14,773.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,954.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,557.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,125.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,079.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,153.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,676.18
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$6,647.85
|
| Rate for Payer: Cash Price |
$6,647.85
|
| Rate for Payer: Cash Price |
$6,647.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,818.40
|
| Rate for Payer: Cigna of CA HMO |
$9,454.72
|
| Rate for Payer: Cigna of CA PPO |
$10,932.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,557.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,557.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,557.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,909.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,909.20
|
| Rate for Payer: Galaxy Health WC |
$12,557.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,863.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,295.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,829.98
|
| Rate for Payer: InnovAge PACE Commercial |
$7,386.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,853.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,230.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,144.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,954.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,341.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,341.10
|
| Rate for Payer: Multiplan Commercial |
$11,079.75
|
| Rate for Payer: Networks By Design Commercial |
$9,602.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,557.05
|
| Rate for Payer: Riverside University Health System MISP |
$5,909.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,863.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,863.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,557.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,557.05
|
| Rate for Payer: Vantage Medical Group Senior |
$12,557.05
|
|
|
HC RESECTION/DEBRID PANCREAS
|
Facility
|
IP
|
$14,773.00
|
|
|
Service Code
|
CPT 48105
|
| Hospital Charge Code |
906748105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,954.60 |
| Max. Negotiated Rate |
$13,295.70 |
| Rate for Payer: Adventist Health Commercial |
$2,954.60
|
| Rate for Payer: Cash Price |
$6,647.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,818.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,909.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,909.20
|
| Rate for Payer: Galaxy Health WC |
$12,557.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,863.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,295.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,853.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,628.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,144.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,954.60
|
| Rate for Payer: Multiplan Commercial |
$11,079.75
|
| Rate for Payer: Networks By Design Commercial |
$9,602.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,557.05
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.42
|
| 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 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 |
$136.08
|
| Rate for Payer: Blue Shield of California Commercial |
$141.57
|
| 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: 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: InnovAge PACE Commercial |
$115.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$154.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$162.19
|
| Rate for Payer: Molina Healthcare of CA 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 RESPIRATORY MINI PANEL
|
Facility
|
OP
|
$334.00
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.77 |
| Max. Negotiated Rate |
$324.08 |
| Rate for Payer: Adventist Health Commercial |
$66.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$142.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$202.84
|
| 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 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 HMO/PPO |
$65.77
|
| Rate for Payer: Blue Shield of California Commercial |
$202.74
|
| Rate for Payer: Blue Shield of California EPN |
$132.60
|
| 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: Cigna of CA HMO |
$213.76
|
| Rate for Payer: Cigna of CA PPO |
$247.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.55
|
| Rate for Payer: EPIC Health Plan Senior |
$142.63
|
| Rate for Payer: Galaxy Health WC |
$283.90
|
| Rate for Payer: Global Benefits Group Commercial |
$200.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$300.60
|
| 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) Medicare Advantage |
$142.63
|
| Rate for Payer: InnovAge PACE Commercial |
$213.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$142.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.12
|
| Rate for Payer: Multiplan Commercial |
$250.50
|
| Rate for Payer: Networks By Design Commercial |
$217.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$142.63
|
| Rate for Payer: Prime Health Services Commercial |
$283.90
|
| Rate for Payer: Prime Health Services Medicare |
$151.19
|
| Rate for Payer: Riverside University Health System MISP |
$156.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.40
|
| 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 HMO |
$115.53
|
| Rate for Payer: United Healthcare HMO Rider |
$115.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$115.53
|
| 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 Medi-Cal |
$156.89
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$261.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$242.65
|
| 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
|
OP
|
$1,496.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$299.20 |
| Max. Negotiated Rate |
$2,400.17 |
| Rate for Payer: Adventist Health Commercial |
$299.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$908.52
|
| 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 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 HMO/PPO |
$487.12
|
| Rate for Payer: Blue Shield of California Commercial |
$908.07
|
| Rate for Payer: Blue Shield of California EPN |
$593.91
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.80
|
| Rate for Payer: Cigna of CA HMO |
$957.44
|
| Rate for Payer: Cigna of CA PPO |
$1,107.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Senior |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,346.40
|
| 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) Medicare Advantage |
$416.78
|
| Rate for Payer: InnovAge PACE Commercial |
$625.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$416.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$416.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
| Rate for Payer: Prime Health Services Medicare |
$441.79
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.60
|
| 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 HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| 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 Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
IP
|
$1,540.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.14 |
| Max. Negotiated Rate |
$1,386.62 |
| Rate for Payer: Adventist Health Commercial |
$308.14
|
| Rate for Payer: Cash Price |
$693.31
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.28
|
| Rate for Payer: EPIC Health Plan Senior |
$616.28
|
| Rate for Payer: Galaxy Health WC |
$1,309.59
|
| Rate for Payer: Global Benefits Group Commercial |
$924.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.14
|
| Rate for Payer: Multiplan Commercial |
$1,155.52
|
| Rate for Payer: Networks By Design Commercial |
$1,001.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.59
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$218.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$203.03
|
| 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 |
$31.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$199.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| 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: 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 |
$46.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: EPIC Health Plan Senior |
$31.12
|
| 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 |
$51.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31.12
|
| Rate for Payer: InnovAge PACE Commercial |
$46.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.70
|
| 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 |
$31.12
|
| Rate for Payer: Prime Health Services Commercial |
$278.80
|
| Rate for Payer: Prime Health Services Medicare |
$32.99
|
| Rate for Payer: Riverside University Health System MISP |
$34.23
|
| 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 |
$31.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Vantage Medical Group Senior |
$31.12
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
IP
|
$1,540.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$308.14 |
| Max. Negotiated Rate |
$1,386.62 |
| Rate for Payer: Adventist Health Commercial |
$308.14
|
| Rate for Payer: Cash Price |
$693.31
|
| Rate for Payer: Central Health Plan Commercial |
$1,232.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.28
|
| Rate for Payer: EPIC Health Plan Senior |
$616.28
|
| Rate for Payer: Galaxy Health WC |
$1,309.59
|
| Rate for Payer: Global Benefits Group Commercial |
$924.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,386.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,027.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$953.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$308.14
|
| Rate for Payer: Multiplan Commercial |
$1,155.52
|
| Rate for Payer: Networks By Design Commercial |
$1,001.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,309.59
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
OP
|
$464.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$2,400.17 |
| Rate for Payer: Adventist Health Commercial |
$92.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$281.79
|
| 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 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 HMO/PPO |
$487.12
|
| Rate for Payer: Blue Shield of California Commercial |
$281.65
|
| Rate for Payer: Blue Shield of California EPN |
$184.21
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Central Health Plan Commercial |
$371.20
|
| Rate for Payer: Cigna of CA HMO |
$296.96
|
| Rate for Payer: Cigna of CA PPO |
$343.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Senior |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$394.40
|
| Rate for Payer: Global Benefits Group Commercial |
$278.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$417.60
|
| 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) Medicare Advantage |
$416.78
|
| Rate for Payer: InnovAge PACE Commercial |
$625.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$309.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$416.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$558.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$558.49
|
| Rate for Payer: Multiplan Commercial |
$348.00
|
| Rate for Payer: Networks By Design Commercial |
$301.60
|
| 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 Medicare |
$441.79
|
| Rate for Payer: Riverside University Health System MISP |
$458.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$278.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$278.40
|
| 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 HMO Rider |
$337.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$337.59
|
| 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 Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
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 |
$2,720.33 |
| Rate for Payer: Adventist Health Commercial |
$570.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,658.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,732.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$812.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,675.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,731.77
|
| 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 |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,239.30
|
| Rate for Payer: EPIC Health Plan Senior |
$1,658.74
|
| 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 |
$2,720.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$303.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: InnovAge PACE Commercial |
$2,488.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,658.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,222.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,222.71
|
| 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 |
$1,658.74
|
| Rate for Payer: Prime Health Services Commercial |
$2,425.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,758.26
|
| Rate for Payer: Riverside University Health System MISP |
$1,824.61
|
| 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 |
$1,658.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$1,902.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,766.01
|
| 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 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 |
$50.94
|
| Rate for Payer: Blue Shield of California Commercial |
$53.00
|
| 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: 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: InnovAge PACE Commercial |
$43.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.72
|
| Rate for Payer: Molina Healthcare of CA 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 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: 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 Permanente of CA Commercial/Self Funded |
$57.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.69
|
| 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 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: 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 Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| 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
|
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 |
$48.16
|
| Rate for Payer: Blue Shield of California Commercial |
$50.10
|
| 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: 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: InnovAge PACE Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA 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 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: 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 Permanente of CA Commercial/Self Funded |
$54.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.86
|
| 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 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 |
$48.25
|
| Rate for Payer: Blue Shield of California Commercial |
$50.20
|
| 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: 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: InnovAge PACE Commercial |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.51
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
