|
HC RESPIRATORY MINI PANEL
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$875.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$142.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$875.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.94
|
| Rate for Payer: Alpha Care Medical Group 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 |
$395.30
|
| Rate for Payer: Blue Distinction Transplant |
$87.00
|
| Rate for Payer: Blue Shield of California Commercial |
$89.61
|
| Rate for Payer: Blue Shield of California EPN |
$70.47
|
| Rate for Payer: Caremore Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Central Health Plan Commercial |
$116.00
|
| Rate for Payer: Cigna of CA HMO |
$92.80
|
| Rate for Payer: Cigna of CA PPO |
$107.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.94
|
| Rate for Payer: Dignity Health Media |
$142.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$142.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$142.63
|
| Rate for Payer: Galaxy Health WC |
$123.25
|
| Rate for Payer: Global Benefits Group Commercial |
$87.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$108.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$233.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$235.34
|
| 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 |
$96.72
|
| 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 |
$29.00
|
| 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 |
$108.75
|
| Rate for Payer: Networks By Design Commercial |
$94.25
|
| Rate for Payer: Prime Health Services Commercial |
$123.25
|
| 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 |
$87.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.00
|
| 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: 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
|
$170.00
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
900913693
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC RESPIRATORY PANEL, NUCLEIC ACID
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$2,987.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group 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 |
$2,927.62
|
| Rate for Payer: Blue Distinction Transplant |
$390.00
|
| Rate for Payer: Blue Shield of California Commercial |
$401.70
|
| Rate for Payer: Blue Shield of California EPN |
$315.90
|
| Rate for Payer: Caremore Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Cigna of CA HMO |
$416.00
|
| Rate for Payer: Cigna of CA PPO |
$481.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Media |
$416.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$416.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$487.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$687.69
|
| 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 |
$433.55
|
| 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 |
$130.00
|
| 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 |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$422.50
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
| 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 |
$390.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$390.00
|
| 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: 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
|
$773.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900913642
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Central Health Plan Commercial |
$618.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$695.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.60
|
| Rate for Payer: Multiplan Commercial |
$579.75
|
| Rate for Payer: Networks By Design Commercial |
$502.45
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
|
|
HC RESP MGT STRENGTH&ENDURC-15MIN
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT G0237
|
| Hospital Charge Code |
900201802
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Central Health Plan Commercial |
$240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.00
|
| Rate for Payer: Galaxy Health WC |
$255.00
|
| Rate for Payer: Global Benefits Group Commercial |
$180.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.00
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: Networks By Design Commercial |
$195.00
|
| Rate for Payer: Prime Health Services Commercial |
$255.00
|
|
|
HC RESP MGT STRENGTH&ENDURC-15MIN
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT G0237
|
| Hospital Charge Code |
900201802
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$22.95 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$180.00
|
| Rate for Payer: Blue Shield of California Commercial |
$188.70
|
| Rate for Payer: Blue Shield of California EPN |
$146.70
|
| Rate for Payer: Caremore Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Central Health Plan Commercial |
$240.00
|
| Rate for Payer: Cigna of CA HMO |
$192.00
|
| Rate for Payer: Cigna of CA PPO |
$222.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Media |
$37.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.20
|
| Rate for Payer: Galaxy Health WC |
$255.00
|
| Rate for Payer: Global Benefits Group Commercial |
$180.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$225.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: InnovAge PACE Commercial |
$55.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$225.00
|
| Rate for Payer: Networks By Design Commercial |
$195.00
|
| Rate for Payer: Prime Health Services Commercial |
$255.00
|
| Rate for Payer: Prime Health Services Medicare |
$39.43
|
| Rate for Payer: Riverside University Health System MISP |
$40.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
IP
|
$812.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Central Health Plan Commercial |
$649.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.80
|
| Rate for Payer: Galaxy Health WC |
$690.20
|
| Rate for Payer: Global Benefits Group Commercial |
$487.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$730.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: Networks By Design Commercial |
$527.80
|
| Rate for Payer: Prime Health Services Commercial |
$690.20
|
|
|
HC RESP VIRUS PANEL NUCLEIC ACID
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
900912337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$2,987.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$416.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,987.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group 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 |
$2,927.62
|
| Rate for Payer: Blue Distinction Transplant |
$121.20
|
| Rate for Payer: Blue Shield of California Commercial |
$124.84
|
| Rate for Payer: Blue Shield of California EPN |
$98.17
|
| Rate for Payer: Caremore Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Central Health Plan Commercial |
$161.60
|
| Rate for Payer: Cigna of CA HMO |
$129.28
|
| Rate for Payer: Cigna of CA PPO |
$149.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Media |
$416.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$562.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$416.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$416.78
|
| Rate for Payer: Galaxy Health WC |
$171.70
|
| Rate for Payer: Global Benefits Group Commercial |
$121.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$181.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$151.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$683.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$687.69
|
| 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 |
$134.73
|
| 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 |
$40.40
|
| 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 |
$151.50
|
| Rate for Payer: Networks By Design Commercial |
$131.30
|
| Rate for Payer: Prime Health Services Commercial |
$171.70
|
| 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 |
$121.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.20
|
| 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: 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
|
IP
|
$3,533.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$706.60 |
| Max. Negotiated Rate |
$3,179.70 |
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,826.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,413.20
|
| Rate for Payer: Galaxy Health WC |
$3,003.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,119.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,179.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,356.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,346.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$706.60
|
| Rate for Payer: Multiplan Commercial |
$2,649.75
|
| Rate for Payer: Networks By Design Commercial |
$2,296.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,003.05
|
|
|
HC RESTING THALLIUM
|
Facility
|
OP
|
$3,533.00
|
|
|
Service Code
|
CPT 78453
|
| Hospital Charge Code |
909301384
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$335.54 |
| Max. Negotiated Rate |
$3,179.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,774.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,374.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$812.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,087.30
|
| Rate for Payer: Blue Distinction Transplant |
$2,119.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,183.39
|
| Rate for Payer: Blue Shield of California EPN |
$1,717.04
|
| Rate for Payer: Caremore Medicare Advantage |
$1,774.15
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,826.40
|
| Rate for Payer: Cigna of CA HMO |
$2,261.12
|
| Rate for Payer: Cigna of CA PPO |
$2,614.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Dignity Health Media |
$1,774.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,951.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,395.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,774.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,774.15
|
| Rate for Payer: Galaxy Health WC |
$3,003.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,119.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,179.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,649.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,909.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,927.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,774.15
|
| Rate for Payer: InnovAge PACE Commercial |
$2,661.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,356.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$335.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,774.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$706.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,377.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,377.36
|
| Rate for Payer: Multiplan Commercial |
$2,649.75
|
| Rate for Payer: Networks By Design Commercial |
$2,296.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,003.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,880.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,951.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,119.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,119.80
|
| 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: Vantage Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,774.15
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
IP
|
$93.25
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$83.92 |
| Rate for Payer: Cash Price |
$41.96
|
| Rate for Payer: Central Health Plan Commercial |
$74.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.30
|
| Rate for Payer: Galaxy Health WC |
$79.26
|
| Rate for Payer: Global Benefits Group Commercial |
$55.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$83.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$69.94
|
| Rate for Payer: Networks By Design Commercial |
$60.61
|
| Rate for Payer: Prime Health Services Commercial |
$79.26
|
|
|
HC RESUSCITATOR INFANT W/AIRFLOW
|
Facility
|
OP
|
$93.25
|
|
| Hospital Charge Code |
901698462
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$83.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$79.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$51.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.09
|
| Rate for Payer: Blue Distinction Transplant |
$55.95
|
| Rate for Payer: Blue Shield of California Commercial |
$58.65
|
| Rate for Payer: Blue Shield of California EPN |
$45.60
|
| Rate for Payer: Cash Price |
$41.96
|
| Rate for Payer: Central Health Plan Commercial |
$74.60
|
| Rate for Payer: Cigna of CA HMO |
$59.68
|
| Rate for Payer: Cigna of CA PPO |
$69.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.26
|
| Rate for Payer: Dignity Health Media |
$79.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$79.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.30
|
| Rate for Payer: Galaxy Health WC |
$79.26
|
| Rate for Payer: Global Benefits Group Commercial |
$55.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$83.92
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$69.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$32.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.65
|
| Rate for Payer: Multiplan Commercial |
$69.94
|
| Rate for Payer: Networks By Design Commercial |
$60.61
|
| Rate for Payer: Prime Health Services Commercial |
$79.26
|
| Rate for Payer: Riverside University Health System MISP |
$37.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.62
|
| Rate for Payer: United Healthcare All Other HMO |
$46.62
|
| Rate for Payer: United Healthcare HMO Rider |
$46.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$79.26
|
| Rate for Payer: Vantage Medical Group Senior |
$79.26
|
|
|
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: 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 |
$45.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.45
|
| Rate for Payer: Blue Distinction Transplant |
$49.20
|
| Rate for Payer: Blue Shield of California Commercial |
$51.58
|
| Rate for Payer: Blue Shield of California EPN |
$40.10
|
| 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 Media |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$61.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.70
|
| 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: 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
|
| 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 Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901605546
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: 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: 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: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
IP
|
$78.47
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$70.62 |
| Rate for Payer: Cash Price |
$35.31
|
| Rate for Payer: Central Health Plan Commercial |
$62.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.39
|
| Rate for Payer: Galaxy Health WC |
$66.70
|
| Rate for Payer: Global Benefits Group Commercial |
$47.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.69
|
| Rate for Payer: Multiplan Commercial |
$58.85
|
| Rate for Payer: Networks By Design Commercial |
$51.01
|
| Rate for Payer: Prime Health Services Commercial |
$66.70
|
|
|
HC RESUSCITATOR MANUAL ADULT SZ S
|
Facility
|
OP
|
$78.47
|
|
| Hospital Charge Code |
901698786
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$70.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: Blue Distinction Transplant |
$47.08
|
| Rate for Payer: Blue Shield of California Commercial |
$49.36
|
| Rate for Payer: Blue Shield of California EPN |
$38.37
|
| Rate for Payer: Cash Price |
$35.31
|
| Rate for Payer: Central Health Plan Commercial |
$62.78
|
| Rate for Payer: Cigna of CA HMO |
$50.22
|
| Rate for Payer: Cigna of CA PPO |
$58.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66.70
|
| Rate for Payer: Dignity Health Media |
$66.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$66.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$31.39
|
| Rate for Payer: Galaxy Health WC |
$66.70
|
| Rate for Payer: Global Benefits Group Commercial |
$47.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.69
|
| Rate for Payer: Multiplan Commercial |
$58.85
|
| Rate for Payer: Networks By Design Commercial |
$51.01
|
| Rate for Payer: Prime Health Services Commercial |
$66.70
|
| Rate for Payer: Riverside University Health System MISP |
$31.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$47.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.24
|
| Rate for Payer: United Healthcare All Other HMO |
$39.24
|
| Rate for Payer: United Healthcare HMO Rider |
$39.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66.70
|
| Rate for Payer: Vantage Medical Group Senior |
$66.70
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
OP
|
$120.31
|
|
| Hospital Charge Code |
901605545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$108.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.08
|
| Rate for Payer: Blue Distinction Transplant |
$72.19
|
| Rate for Payer: Blue Shield of California Commercial |
$75.67
|
| Rate for Payer: Blue Shield of California EPN |
$58.83
|
| Rate for Payer: Cash Price |
$54.14
|
| Rate for Payer: Central Health Plan Commercial |
$96.25
|
| Rate for Payer: Cigna of CA HMO |
$77.00
|
| Rate for Payer: Cigna of CA PPO |
$89.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.26
|
| Rate for Payer: Dignity Health Media |
$102.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$48.12
|
| Rate for Payer: Galaxy Health WC |
$102.26
|
| Rate for Payer: Global Benefits Group Commercial |
$72.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.28
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$90.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$42.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.06
|
| Rate for Payer: Multiplan Commercial |
$90.23
|
| Rate for Payer: Networks By Design Commercial |
$78.20
|
| Rate for Payer: Prime Health Services Commercial |
$102.26
|
| Rate for Payer: Riverside University Health System MISP |
$48.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.16
|
| Rate for Payer: United Healthcare All Other HMO |
$60.16
|
| Rate for Payer: United Healthcare HMO Rider |
$60.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.26
|
| Rate for Payer: Vantage Medical Group Senior |
$102.26
|
|
|
HC RESUSCITATOR MANUAL INFANT
|
Facility
|
IP
|
$120.31
|
|
| Hospital Charge Code |
901605545
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$108.28 |
| Rate for Payer: Cash Price |
$54.14
|
| Rate for Payer: Central Health Plan Commercial |
$96.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.12
|
| Rate for Payer: Galaxy Health WC |
$102.26
|
| Rate for Payer: Global Benefits Group Commercial |
$72.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.06
|
| Rate for Payer: Multiplan Commercial |
$90.23
|
| Rate for Payer: Networks By Design Commercial |
$78.20
|
| Rate for Payer: Prime Health Services Commercial |
$102.26
|
|
|
HC RESUSCITATOR MANUAL PEDS
|
Facility
|
OP
|
$152.00
|
|
| Hospital Charge Code |
901605544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.80
|
| Rate for Payer: Blue Distinction Transplant |
$91.20
|
| Rate for Payer: Blue Shield of California Commercial |
$95.61
|
| Rate for Payer: Blue Shield of California EPN |
$74.33
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Media |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$114.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC RESUSCITATOR MANUAL PEDS
|
Facility
|
IP
|
$152.00
|
|
| Hospital Charge Code |
901605544
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC RESUSCITATOR PEDS MANUAL
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901698464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| 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 |
$45.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.45
|
| Rate for Payer: Blue Distinction Transplant |
$49.20
|
| Rate for Payer: Blue Shield of California Commercial |
$51.58
|
| Rate for Payer: Blue Shield of California EPN |
$40.10
|
| 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 Media |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$61.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.70
|
| 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: 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
|
| 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 Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC RESUSCITATOR PEDS MANUAL
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901698464
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| 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: 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: 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 PEDS SIZE 1 & 2
|
Facility
|
IP
|
$231.70
|
|
| Hospital Charge Code |
901698718
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| Rate for Payer: Cash Price |
$104.27
|
| Rate for Payer: Central Health Plan Commercial |
$185.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 RESUSCITATOR PEDS SIZE 1 & 2
|
Facility
|
OP
|
$231.70
|
|
| Hospital Charge Code |
901698718
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$208.53 |
| 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 |
$127.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.89
|
| Rate for Payer: Blue Distinction Transplant |
$139.02
|
| Rate for Payer: Blue Shield of California Commercial |
$145.74
|
| Rate for Payer: Blue Shield of California EPN |
$113.30
|
| Rate for Payer: Cash Price |
$104.27
|
| 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 Media |
$196.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$196.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$173.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$81.10
|
| 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: 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
|
| 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 Medi-Cal |
$196.94
|
| Rate for Payer: Vantage Medical Group Senior |
$196.94
|
|
|
HC RESUSCITATOR PEDS SPUR II
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901698465
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| 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: 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: 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
|
|
