|
HC RSPR T-POD PELVIC STBL
|
Facility
|
OP
|
$585.12
|
|
|
Service Code
|
CPT E0944
|
| Hospital Charge Code |
901698449
|
|
Hospital Revenue Code
|
290
|
| Min. Negotiated Rate |
$59.28 |
| Max. Negotiated Rate |
$526.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$120.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$497.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$321.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$345.69
|
| Rate for Payer: Blue Distinction Transplant |
$351.07
|
| Rate for Payer: Blue Shield of California Commercial |
$368.04
|
| Rate for Payer: Blue Shield of California EPN |
$286.12
|
| Rate for Payer: Cash Price |
$263.30
|
| Rate for Payer: Cash Price |
$263.30
|
| Rate for Payer: Central Health Plan Commercial |
$468.10
|
| Rate for Payer: Cigna of CA HMO |
$374.48
|
| Rate for Payer: Cigna of CA PPO |
$432.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$497.35
|
| Rate for Payer: Dignity Health Media |
$497.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$497.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$234.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$234.05
|
| Rate for Payer: Galaxy Health WC |
$497.35
|
| Rate for Payer: Global Benefits Group Commercial |
$351.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$526.61
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$438.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$204.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$390.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$117.02
|
| Rate for Payer: Multiplan Commercial |
$438.84
|
| Rate for Payer: Networks By Design Commercial |
$380.33
|
| Rate for Payer: Prime Health Services Commercial |
$497.35
|
| Rate for Payer: Riverside University Health System MISP |
$234.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$351.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$351.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$292.56
|
| Rate for Payer: United Healthcare All Other HMO |
$292.56
|
| Rate for Payer: United Healthcare HMO Rider |
$292.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$292.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$497.35
|
| Rate for Payer: Vantage Medical Group Senior |
$497.35
|
|
|
HC RSV AG
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 87420
|
| Hospital Charge Code |
900911613
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$79.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.75
|
| Rate for Payer: Blue Distinction Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.07
|
| Rate for Payer: Blue Shield of California EPN |
$12.64
|
| Rate for Payer: Caremore Medicare Advantage |
$13.91
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.86
|
| Rate for Payer: Dignity Health Media |
$13.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.91
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.91
|
| Rate for Payer: InnovAge PACE Commercial |
$20.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.64
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Medicare |
$14.74
|
| Rate for Payer: Riverside University Health System MISP |
$15.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.27
|
| Rate for Payer: United Healthcare All Other HMO |
$11.27
|
| Rate for Payer: United Healthcare HMO Rider |
$11.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.30
|
| Rate for Payer: Vantage Medical Group Senior |
$13.91
|
|
|
HC RSV AG
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
CPT 87420
|
| Hospital Charge Code |
900911613
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$170.10 |
| Rate for Payer: Cash Price |
$85.05
|
| Rate for Payer: Central Health Plan Commercial |
$151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.60
|
| Rate for Payer: Galaxy Health WC |
$160.65
|
| Rate for Payer: Global Benefits Group Commercial |
$113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$170.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$126.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.80
|
| Rate for Payer: Multiplan Commercial |
$141.75
|
| Rate for Payer: Networks By Design Commercial |
$122.85
|
| Rate for Payer: Prime Health Services Commercial |
$160.65
|
|
|
HC RSV DFA
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
900911537
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$79.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.75
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$17.50
|
| Rate for Payer: Caremore Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.13
|
| Rate for Payer: Dignity Health Media |
$13.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.42
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.42
|
| Rate for Payer: InnovAge PACE Commercial |
$20.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.98
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Medicare |
$14.23
|
| Rate for Payer: Riverside University Health System MISP |
$14.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.87
|
| Rate for Payer: United Healthcare All Other HMO |
$10.87
|
| Rate for Payer: United Healthcare HMO Rider |
$10.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.76
|
| Rate for Payer: Vantage Medical Group Senior |
$13.42
|
|
|
HC RSV DFA
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
900911537
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$305.10 |
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Central Health Plan Commercial |
$271.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$305.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.80
|
| Rate for Payer: Multiplan Commercial |
$254.25
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC RT ATTENDANCE AT DELIVERY
|
Facility
|
OP
|
$1,388.00
|
|
|
Service Code
|
CPT 99464
|
| Hospital Charge Code |
900800499
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$1,249.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$371.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,179.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$763.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$672.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$820.03
|
| Rate for Payer: Blue Distinction Transplant |
$832.80
|
| Rate for Payer: Blue Shield of California Commercial |
$857.78
|
| Rate for Payer: Blue Shield of California EPN |
$674.57
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,110.40
|
| Rate for Payer: Cigna of CA HMO |
$888.32
|
| Rate for Payer: Cigna of CA PPO |
$1,027.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,179.80
|
| Rate for Payer: Dignity Health Media |
$1,179.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,179.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$555.20
|
| Rate for Payer: Galaxy Health WC |
$1,179.80
|
| Rate for Payer: Global Benefits Group Commercial |
$832.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,249.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,041.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$485.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$925.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.60
|
| Rate for Payer: Multiplan Commercial |
$1,041.00
|
| Rate for Payer: Networks By Design Commercial |
$902.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,179.80
|
| Rate for Payer: Riverside University Health System MISP |
$555.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$832.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$832.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,179.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,179.80
|
|
|
HC RT ATTENDANCE AT DELIVERY
|
Facility
|
IP
|
$1,388.00
|
|
|
Service Code
|
CPT 99464
|
| Hospital Charge Code |
900800499
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$1,249.20 |
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,110.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.20
|
| Rate for Payer: Galaxy Health WC |
$1,179.80
|
| Rate for Payer: Global Benefits Group Commercial |
$832.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,249.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$925.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.60
|
| Rate for Payer: Multiplan Commercial |
$1,041.00
|
| Rate for Payer: Networks By Design Commercial |
$902.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,179.80
|
|
|
HC RTNR BANDNET DRSNG 50YD X 6IN
|
Facility
|
IP
|
$6.31
|
|
| Hospital Charge Code |
901698302
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$5.68 |
| Rate for Payer: Cash Price |
$2.84
|
| Rate for Payer: Central Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.52
|
| Rate for Payer: Galaxy Health WC |
$5.36
|
| Rate for Payer: Global Benefits Group Commercial |
$3.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$4.73
|
| Rate for Payer: Networks By Design Commercial |
$4.10
|
| Rate for Payer: Prime Health Services Commercial |
$5.36
|
|
|
HC RTNR BANDNET DRSNG 50YD X 6IN
|
Facility
|
OP
|
$6.31
|
|
| Hospital Charge Code |
901698302
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$5.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.73
|
| Rate for Payer: Blue Distinction Transplant |
$3.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3.97
|
| Rate for Payer: Blue Shield of California EPN |
$3.09
|
| Rate for Payer: Cash Price |
$2.84
|
| Rate for Payer: Central Health Plan Commercial |
$5.05
|
| Rate for Payer: Cigna of CA HMO |
$4.04
|
| Rate for Payer: Cigna of CA PPO |
$4.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.36
|
| Rate for Payer: Dignity Health Media |
$5.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.52
|
| Rate for Payer: Galaxy Health WC |
$5.36
|
| Rate for Payer: Global Benefits Group Commercial |
$3.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$4.73
|
| Rate for Payer: Networks By Design Commercial |
$4.10
|
| Rate for Payer: Prime Health Services Commercial |
$5.36
|
| Rate for Payer: Riverside University Health System MISP |
$2.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.16
|
| Rate for Payer: United Healthcare All Other HMO |
$3.16
|
| Rate for Payer: United Healthcare HMO Rider |
$3.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.36
|
| Rate for Payer: Vantage Medical Group Senior |
$5.36
|
|
|
HC RTNR BANDNET DRSNG 50YD X 7IN
|
Facility
|
OP
|
$7.13
|
|
| Hospital Charge Code |
901698298
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.21
|
| Rate for Payer: Blue Distinction Transplant |
$4.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4.48
|
| Rate for Payer: Blue Shield of California EPN |
$3.49
|
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Central Health Plan Commercial |
$5.70
|
| Rate for Payer: Cigna of CA HMO |
$4.56
|
| Rate for Payer: Cigna of CA PPO |
$5.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.06
|
| Rate for Payer: Dignity Health Media |
$6.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.85
|
| Rate for Payer: Galaxy Health WC |
$6.06
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.42
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.43
|
| Rate for Payer: Multiplan Commercial |
$5.35
|
| Rate for Payer: Networks By Design Commercial |
$4.63
|
| Rate for Payer: Prime Health Services Commercial |
$6.06
|
| Rate for Payer: Riverside University Health System MISP |
$2.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.56
|
| Rate for Payer: United Healthcare All Other HMO |
$3.56
|
| Rate for Payer: United Healthcare HMO Rider |
$3.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$6.06
|
|
|
HC RTNR BANDNET DRSNG 50YD X 7IN
|
Facility
|
IP
|
$7.13
|
|
| Hospital Charge Code |
901698298
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.42 |
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Central Health Plan Commercial |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.85
|
| Rate for Payer: Galaxy Health WC |
$6.06
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.43
|
| Rate for Payer: Multiplan Commercial |
$5.35
|
| Rate for Payer: Networks By Design Commercial |
$4.63
|
| Rate for Payer: Prime Health Services Commercial |
$6.06
|
|
|
HC RTNR DRSNG BANDNET 25YD X 6IN
|
Facility
|
OP
|
$8.53
|
|
| Hospital Charge Code |
901698260
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.04
|
| Rate for Payer: Blue Distinction Transplant |
$5.12
|
| Rate for Payer: Blue Shield of California Commercial |
$5.37
|
| Rate for Payer: Blue Shield of California EPN |
$4.17
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: Cigna of CA HMO |
$5.46
|
| Rate for Payer: Cigna of CA PPO |
$6.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.25
|
| Rate for Payer: Dignity Health Media |
$7.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
| Rate for Payer: Riverside University Health System MISP |
$3.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.26
|
| Rate for Payer: United Healthcare All Other HMO |
$4.26
|
| Rate for Payer: United Healthcare HMO Rider |
$4.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
|
|
HC RTNR DRSNG BANDNET 25YD X 6IN
|
Facility
|
IP
|
$8.53
|
|
| Hospital Charge Code |
901698260
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
|
|
HC RTNR DRSNG BANDNET 5INX50YD
|
Facility
|
OP
|
$8.53
|
|
| Hospital Charge Code |
901698322
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.04
|
| Rate for Payer: Blue Distinction Transplant |
$5.12
|
| Rate for Payer: Blue Shield of California Commercial |
$5.37
|
| Rate for Payer: Blue Shield of California EPN |
$4.17
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: Cigna of CA HMO |
$5.46
|
| Rate for Payer: Cigna of CA PPO |
$6.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.25
|
| Rate for Payer: Dignity Health Media |
$7.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
| Rate for Payer: Riverside University Health System MISP |
$3.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.26
|
| Rate for Payer: United Healthcare All Other HMO |
$4.26
|
| Rate for Payer: United Healthcare HMO Rider |
$4.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
|
|
HC RTNR DRSNG BANDNET 5INX50YD
|
Facility
|
IP
|
$8.53
|
|
| Hospital Charge Code |
901698322
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$7.68 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
|
|
HC RTNR DRSNG BANDNET 8INX50YD
|
Facility
|
OP
|
$4.59
|
|
| Hospital Charge Code |
901698274
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.71
|
| Rate for Payer: Blue Distinction Transplant |
$2.75
|
| Rate for Payer: Blue Shield of California Commercial |
$2.89
|
| Rate for Payer: Blue Shield of California EPN |
$2.24
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$3.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.90
|
| Rate for Payer: Dignity Health Media |
$3.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
| Rate for Payer: Riverside University Health System MISP |
$1.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.30
|
| Rate for Payer: United Healthcare All Other HMO |
$2.30
|
| Rate for Payer: United Healthcare HMO Rider |
$2.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3.90
|
|
|
HC RTNR DRSNG BANDNET 8INX50YD
|
Facility
|
IP
|
$4.59
|
|
| Hospital Charge Code |
901698274
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Central Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.44
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
|
|
HC RTNR DRSNG BANDNET 9IN
|
Facility
|
OP
|
$10.25
|
|
| Hospital Charge Code |
901698412
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.06
|
| Rate for Payer: Blue Distinction Transplant |
$6.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.45
|
| Rate for Payer: Blue Shield of California EPN |
$5.01
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Central Health Plan Commercial |
$8.20
|
| Rate for Payer: Cigna of CA HMO |
$6.56
|
| Rate for Payer: Cigna of CA PPO |
$7.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.71
|
| Rate for Payer: Dignity Health Media |
$8.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.10
|
| Rate for Payer: Galaxy Health WC |
$8.71
|
| Rate for Payer: Global Benefits Group Commercial |
$6.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.22
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Multiplan Commercial |
$7.69
|
| Rate for Payer: Networks By Design Commercial |
$6.66
|
| Rate for Payer: Prime Health Services Commercial |
$8.71
|
| Rate for Payer: Riverside University Health System MISP |
$4.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.12
|
| Rate for Payer: United Healthcare All Other HMO |
$5.12
|
| Rate for Payer: United Healthcare HMO Rider |
$5.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.71
|
| Rate for Payer: Vantage Medical Group Senior |
$8.71
|
|
|
HC RTNR DRSNG BANDNET 9IN
|
Facility
|
IP
|
$10.25
|
|
| Hospital Charge Code |
901698412
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Central Health Plan Commercial |
$8.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.10
|
| Rate for Payer: Galaxy Health WC |
$8.71
|
| Rate for Payer: Global Benefits Group Commercial |
$6.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Multiplan Commercial |
$7.69
|
| Rate for Payer: Networks By Design Commercial |
$6.66
|
| Rate for Payer: Prime Health Services Commercial |
$8.71
|
|
|
HC RTNR DRSNG SURGIFIX SZ 1
|
Facility
|
OP
|
$17.47
|
|
| Hospital Charge Code |
901601028
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.32
|
| Rate for Payer: Blue Distinction Transplant |
$10.48
|
| Rate for Payer: Blue Shield of California Commercial |
$10.99
|
| Rate for Payer: Blue Shield of California EPN |
$8.54
|
| Rate for Payer: Cash Price |
$7.86
|
| Rate for Payer: Central Health Plan Commercial |
$13.98
|
| Rate for Payer: Cigna of CA HMO |
$11.18
|
| Rate for Payer: Cigna of CA PPO |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.85
|
| Rate for Payer: Dignity Health Media |
$14.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.99
|
| Rate for Payer: Galaxy Health WC |
$14.85
|
| Rate for Payer: Global Benefits Group Commercial |
$10.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.72
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.49
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$11.36
|
| Rate for Payer: Prime Health Services Commercial |
$14.85
|
| Rate for Payer: Riverside University Health System MISP |
$6.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.74
|
| Rate for Payer: United Healthcare All Other HMO |
$8.74
|
| Rate for Payer: United Healthcare HMO Rider |
$8.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.85
|
|
|
HC RTNR DRSNG SURGIFIX SZ 1
|
Facility
|
IP
|
$17.47
|
|
| Hospital Charge Code |
901601028
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Cash Price |
$7.86
|
| Rate for Payer: Central Health Plan Commercial |
$13.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: Galaxy Health WC |
$14.85
|
| Rate for Payer: Global Benefits Group Commercial |
$10.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.49
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$11.36
|
| Rate for Payer: Prime Health Services Commercial |
$14.85
|
|
|
HC RTNR DRSNG SURGIFIX SZ 10
|
Facility
|
OP
|
$22.71
|
|
| Hospital Charge Code |
901601037
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$20.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.42
|
| Rate for Payer: Blue Distinction Transplant |
$13.63
|
| Rate for Payer: Blue Shield of California Commercial |
$14.28
|
| Rate for Payer: Blue Shield of California EPN |
$11.11
|
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Central Health Plan Commercial |
$18.17
|
| Rate for Payer: Cigna of CA HMO |
$14.53
|
| Rate for Payer: Cigna of CA PPO |
$16.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Media |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.08
|
| Rate for Payer: Galaxy Health WC |
$19.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.44
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$17.03
|
| Rate for Payer: Networks By Design Commercial |
$14.76
|
| Rate for Payer: Prime Health Services Commercial |
$19.30
|
| Rate for Payer: Riverside University Health System MISP |
$9.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.36
|
| Rate for Payer: United Healthcare All Other HMO |
$11.36
|
| Rate for Payer: United Healthcare HMO Rider |
$11.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.30
|
| Rate for Payer: Vantage Medical Group Senior |
$19.30
|
|
|
HC RTNR DRSNG SURGIFIX SZ 10
|
Facility
|
IP
|
$22.71
|
|
| Hospital Charge Code |
901601037
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$20.44 |
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Central Health Plan Commercial |
$18.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.08
|
| Rate for Payer: Galaxy Health WC |
$19.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$17.03
|
| Rate for Payer: Networks By Design Commercial |
$14.76
|
| Rate for Payer: Prime Health Services Commercial |
$19.30
|
|
|
HC RTNR DRSNG SURGIFIX SZ 2
|
Facility
|
OP
|
$10.66
|
|
| Hospital Charge Code |
901601029
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.30
|
| Rate for Payer: Blue Distinction Transplant |
$6.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6.71
|
| Rate for Payer: Blue Shield of California EPN |
$5.21
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.53
|
| Rate for Payer: Cigna of CA HMO |
$6.82
|
| Rate for Payer: Cigna of CA PPO |
$7.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: Dignity Health Media |
$9.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.26
|
| Rate for Payer: Galaxy Health WC |
$9.06
|
| Rate for Payer: Global Benefits Group Commercial |
$6.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.59
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.93
|
| Rate for Payer: Prime Health Services Commercial |
$9.06
|
| Rate for Payer: Riverside University Health System MISP |
$4.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare HMO Rider |
$5.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.06
|
| Rate for Payer: Vantage Medical Group Senior |
$9.06
|
|
|
HC RTNR DRSNG SURGIFIX SZ 2
|
Facility
|
IP
|
$10.66
|
|
| Hospital Charge Code |
901601029
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.26
|
| Rate for Payer: Galaxy Health WC |
$9.06
|
| Rate for Payer: Global Benefits Group Commercial |
$6.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.93
|
| Rate for Payer: Prime Health Services Commercial |
$9.06
|
|
