|
HC RTNR DRSNG SURGIFIX SZ 3
|
Facility
|
IP
|
$6.89
|
|
| Hospital Charge Code |
901601030
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Central Health Plan Commercial |
$5.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: Galaxy Health WC |
$5.86
|
| Rate for Payer: Global Benefits Group Commercial |
$4.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$5.17
|
| Rate for Payer: Networks By Design Commercial |
$4.48
|
| Rate for Payer: Prime Health Services Commercial |
$5.86
|
|
|
HC RTNR DRSNG SURGIFIX SZ 3
|
Facility
|
OP
|
$6.89
|
|
| Hospital Charge Code |
901601030
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$6.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.07
|
| Rate for Payer: Blue Distinction Transplant |
$4.13
|
| Rate for Payer: Blue Shield of California Commercial |
$4.33
|
| Rate for Payer: Blue Shield of California EPN |
$3.37
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Central Health Plan Commercial |
$5.51
|
| Rate for Payer: Cigna of CA HMO |
$4.41
|
| Rate for Payer: Cigna of CA PPO |
$5.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.86
|
| Rate for Payer: Dignity Health Media |
$5.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.76
|
| Rate for Payer: Galaxy Health WC |
$5.86
|
| Rate for Payer: Global Benefits Group Commercial |
$4.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$5.17
|
| Rate for Payer: Networks By Design Commercial |
$4.48
|
| Rate for Payer: Prime Health Services Commercial |
$5.86
|
| Rate for Payer: Riverside University Health System MISP |
$2.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.44
|
| Rate for Payer: United Healthcare All Other HMO |
$3.44
|
| Rate for Payer: United Healthcare HMO Rider |
$3.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.86
|
| Rate for Payer: Vantage Medical Group Senior |
$5.86
|
|
|
HC RTNR DRSNG SURGIFIX SZ 4
|
Facility
|
OP
|
$4.84
|
|
| Hospital Charge Code |
901601031
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$4.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.86
|
| Rate for Payer: Blue Distinction Transplant |
$2.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3.04
|
| Rate for Payer: Blue Shield of California EPN |
$2.37
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Central Health Plan Commercial |
$3.87
|
| Rate for Payer: Cigna of CA HMO |
$3.10
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.11
|
| Rate for Payer: Dignity Health Media |
$4.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.94
|
| Rate for Payer: Galaxy Health WC |
$4.11
|
| Rate for Payer: Global Benefits Group Commercial |
$2.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.36
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.97
|
| Rate for Payer: Multiplan Commercial |
$3.63
|
| Rate for Payer: Networks By Design Commercial |
$3.15
|
| Rate for Payer: Prime Health Services Commercial |
$4.11
|
| Rate for Payer: Riverside University Health System MISP |
$1.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.42
|
| Rate for Payer: United Healthcare All Other HMO |
$2.42
|
| Rate for Payer: United Healthcare HMO Rider |
$2.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.11
|
| Rate for Payer: Vantage Medical Group Senior |
$4.11
|
|
|
HC RTNR DRSNG SURGIFIX SZ 4
|
Facility
|
IP
|
$4.84
|
|
| Hospital Charge Code |
901601031
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$4.36 |
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Central Health Plan Commercial |
$3.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.94
|
| Rate for Payer: Galaxy Health WC |
$4.11
|
| Rate for Payer: Global Benefits Group Commercial |
$2.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.97
|
| Rate for Payer: Multiplan Commercial |
$3.63
|
| Rate for Payer: Networks By Design Commercial |
$3.15
|
| Rate for Payer: Prime Health Services Commercial |
$4.11
|
|
|
HC RTNR DRSNG SURGIFIX SZ 5
|
Facility
|
IP
|
$2.13
|
|
| Hospital Charge Code |
901601032
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$1.92 |
| Rate for Payer: Cash Price |
$0.96
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.81
|
| Rate for Payer: Global Benefits Group Commercial |
$1.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$1.60
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.81
|
|
|
HC RTNR DRSNG SURGIFIX SZ 5
|
Facility
|
OP
|
$2.13
|
|
| Hospital Charge Code |
901601032
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$1.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.26
|
| Rate for Payer: Blue Distinction Transplant |
$1.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1.34
|
| Rate for Payer: Blue Shield of California EPN |
$1.04
|
| Rate for Payer: Cash Price |
$0.96
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: Cigna of CA HMO |
$1.36
|
| Rate for Payer: Cigna of CA PPO |
$1.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.81
|
| Rate for Payer: Dignity Health Media |
$1.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.81
|
| Rate for Payer: Global Benefits Group Commercial |
$1.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.92
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$1.60
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.81
|
| Rate for Payer: Riverside University Health System MISP |
$0.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.06
|
| Rate for Payer: United Healthcare All Other HMO |
$1.06
|
| Rate for Payer: United Healthcare HMO Rider |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1.81
|
|
|
HC RTNR DRSNG SURGIFIX SZ 6
|
Facility
|
IP
|
$5.49
|
|
| Hospital Charge Code |
901601033
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$4.94 |
| Rate for Payer: Cash Price |
$2.47
|
| Rate for Payer: Central Health Plan Commercial |
$4.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.20
|
| Rate for Payer: Galaxy Health WC |
$4.67
|
| Rate for Payer: Global Benefits Group Commercial |
$3.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$4.12
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Prime Health Services Commercial |
$4.67
|
|
|
HC RTNR DRSNG SURGIFIX SZ 6
|
Facility
|
OP
|
$5.49
|
|
| Hospital Charge Code |
901601033
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$4.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.24
|
| Rate for Payer: Blue Distinction Transplant |
$3.29
|
| Rate for Payer: Blue Shield of California Commercial |
$3.45
|
| Rate for Payer: Blue Shield of California EPN |
$2.68
|
| Rate for Payer: Cash Price |
$2.47
|
| Rate for Payer: Central Health Plan Commercial |
$4.39
|
| Rate for Payer: Cigna of CA HMO |
$3.51
|
| Rate for Payer: Cigna of CA PPO |
$4.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.67
|
| Rate for Payer: Dignity Health Media |
$4.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.20
|
| Rate for Payer: Galaxy Health WC |
$4.67
|
| Rate for Payer: Global Benefits Group Commercial |
$3.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.94
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$4.12
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Prime Health Services Commercial |
$4.67
|
| Rate for Payer: Riverside University Health System MISP |
$2.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.74
|
| Rate for Payer: United Healthcare All Other HMO |
$2.74
|
| Rate for Payer: United Healthcare HMO Rider |
$2.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Vantage Medical Group Senior |
$4.67
|
|
|
HC RTNR DRSNG SURGIFIX SZ 7
|
Facility
|
OP
|
$24.03
|
|
| Hospital Charge Code |
901601034
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.20
|
| Rate for Payer: Blue Distinction Transplant |
$14.42
|
| Rate for Payer: Blue Shield of California Commercial |
$15.11
|
| Rate for Payer: Blue Shield of California EPN |
$11.75
|
| Rate for Payer: Cash Price |
$10.81
|
| Rate for Payer: Central Health Plan Commercial |
$19.22
|
| Rate for Payer: Cigna of CA HMO |
$15.38
|
| Rate for Payer: Cigna of CA PPO |
$17.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.43
|
| Rate for Payer: Dignity Health Media |
$20.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.61
|
| Rate for Payer: Galaxy Health WC |
$20.43
|
| Rate for Payer: Global Benefits Group Commercial |
$14.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.63
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.81
|
| Rate for Payer: Multiplan Commercial |
$18.02
|
| Rate for Payer: Networks By Design Commercial |
$15.62
|
| Rate for Payer: Prime Health Services Commercial |
$20.43
|
| Rate for Payer: Riverside University Health System MISP |
$9.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.02
|
| Rate for Payer: United Healthcare All Other HMO |
$12.02
|
| Rate for Payer: United Healthcare HMO Rider |
$12.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.43
|
| Rate for Payer: Vantage Medical Group Senior |
$20.43
|
|
|
HC RTNR DRSNG SURGIFIX SZ 7
|
Facility
|
IP
|
$24.03
|
|
| Hospital Charge Code |
901601034
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Cash Price |
$10.81
|
| Rate for Payer: Central Health Plan Commercial |
$19.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.61
|
| Rate for Payer: Galaxy Health WC |
$20.43
|
| Rate for Payer: Global Benefits Group Commercial |
$14.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.81
|
| Rate for Payer: Multiplan Commercial |
$18.02
|
| Rate for Payer: Networks By Design Commercial |
$15.62
|
| Rate for Payer: Prime Health Services Commercial |
$20.43
|
|
|
HC RTNR DRSNG SURGIFIX SZ 8
|
Facility
|
IP
|
$9.68
|
|
| Hospital Charge Code |
901601035
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Central Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.87
|
| Rate for Payer: Galaxy Health WC |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$5.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: Multiplan Commercial |
$7.26
|
| Rate for Payer: Networks By Design Commercial |
$6.29
|
| Rate for Payer: Prime Health Services Commercial |
$8.23
|
|
|
HC RTNR DRSNG SURGIFIX SZ 8
|
Facility
|
OP
|
$9.68
|
|
| Hospital Charge Code |
901601035
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.72
|
| Rate for Payer: Blue Distinction Transplant |
$5.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6.09
|
| Rate for Payer: Blue Shield of California EPN |
$4.73
|
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Central Health Plan Commercial |
$7.74
|
| Rate for Payer: Cigna of CA HMO |
$6.20
|
| Rate for Payer: Cigna of CA PPO |
$7.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.23
|
| Rate for Payer: Dignity Health Media |
$8.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.87
|
| Rate for Payer: Galaxy Health WC |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$5.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.71
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: Multiplan Commercial |
$7.26
|
| Rate for Payer: Networks By Design Commercial |
$6.29
|
| Rate for Payer: Prime Health Services Commercial |
$8.23
|
| Rate for Payer: Riverside University Health System MISP |
$3.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.84
|
| Rate for Payer: United Healthcare All Other HMO |
$4.84
|
| Rate for Payer: United Healthcare HMO Rider |
$4.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$8.23
|
|
|
HC RTNR DRSNG SURGIFIX SZ 9
|
Facility
|
OP
|
$273.98
|
|
| Hospital Charge Code |
901601036
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$246.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$132.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.87
|
| Rate for Payer: Blue Distinction Transplant |
$164.39
|
| Rate for Payer: Blue Shield of California Commercial |
$172.33
|
| Rate for Payer: Blue Shield of California EPN |
$133.98
|
| Rate for Payer: Cash Price |
$123.29
|
| Rate for Payer: Central Health Plan Commercial |
$219.18
|
| Rate for Payer: Cigna of CA HMO |
$175.35
|
| Rate for Payer: Cigna of CA PPO |
$202.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.88
|
| Rate for Payer: Dignity Health Media |
$232.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.59
|
| Rate for Payer: Galaxy Health WC |
$232.88
|
| Rate for Payer: Global Benefits Group Commercial |
$164.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$246.58
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$205.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$95.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.80
|
| Rate for Payer: Multiplan Commercial |
$205.48
|
| Rate for Payer: Networks By Design Commercial |
$178.09
|
| Rate for Payer: Prime Health Services Commercial |
$232.88
|
| Rate for Payer: Riverside University Health System MISP |
$109.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.99
|
| Rate for Payer: United Healthcare All Other HMO |
$136.99
|
| Rate for Payer: United Healthcare HMO Rider |
$136.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.88
|
| Rate for Payer: Vantage Medical Group Senior |
$232.88
|
|
|
HC RTNR DRSNG SURGIFIX SZ 9
|
Facility
|
IP
|
$273.98
|
|
| Hospital Charge Code |
901601036
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$246.58 |
| Rate for Payer: Cash Price |
$123.29
|
| Rate for Payer: Central Health Plan Commercial |
$219.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.59
|
| Rate for Payer: Galaxy Health WC |
$232.88
|
| Rate for Payer: Global Benefits Group Commercial |
$164.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$246.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.80
|
| Rate for Payer: Multiplan Commercial |
$205.48
|
| Rate for Payer: Networks By Design Commercial |
$178.09
|
| Rate for Payer: Prime Health Services Commercial |
$232.88
|
|
|
HC RTNR DRSNG SZ 7, 28"X25YD
|
Facility
|
OP
|
$3.85
|
|
| Hospital Charge Code |
901698689
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.27
|
| Rate for Payer: Blue Distinction Transplant |
$2.31
|
| Rate for Payer: Blue Shield of California Commercial |
$2.42
|
| Rate for Payer: Blue Shield of California EPN |
$1.88
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Media |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC RTNR DRSNG SZ 7, 28"X25YD
|
Facility
|
IP
|
$3.85
|
|
| Hospital Charge Code |
901698689
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC RTNR DRSNG TUBULAR SZ 5 25YDS
|
Facility
|
OP
|
$1.80
|
|
| Hospital Charge Code |
901698748
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$1.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.06
|
| Rate for Payer: Blue Distinction Transplant |
$1.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Cash Price |
$0.81
|
| Rate for Payer: Central Health Plan Commercial |
$1.44
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.53
|
| Rate for Payer: Dignity Health Media |
$1.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.72
|
| Rate for Payer: Galaxy Health WC |
$1.53
|
| Rate for Payer: Global Benefits Group Commercial |
$1.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.36
|
| Rate for Payer: Multiplan Commercial |
$1.35
|
| Rate for Payer: Networks By Design Commercial |
$1.17
|
| Rate for Payer: Prime Health Services Commercial |
$1.53
|
| Rate for Payer: Riverside University Health System MISP |
$0.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.90
|
| Rate for Payer: United Healthcare All Other HMO |
$0.90
|
| Rate for Payer: United Healthcare HMO Rider |
$0.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1.53
|
|
|
HC RTNR DRSNG TUBULAR SZ 5 25YDS
|
Facility
|
IP
|
$1.80
|
|
| Hospital Charge Code |
901698748
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$1.62 |
| Rate for Payer: Cash Price |
$0.81
|
| Rate for Payer: Central Health Plan Commercial |
$1.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: Galaxy Health WC |
$1.53
|
| Rate for Payer: Global Benefits Group Commercial |
$1.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.36
|
| Rate for Payer: Multiplan Commercial |
$1.35
|
| Rate for Payer: Networks By Design Commercial |
$1.17
|
| Rate for Payer: Prime Health Services Commercial |
$1.53
|
|
|
HC RTNR DRSNG TUBULAR SZ 6 25YDS
|
Facility
|
IP
|
$2.30
|
|
| Hospital Charge Code |
901698749
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$2.07 |
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Central Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.92
|
| Rate for Payer: Galaxy Health WC |
$1.96
|
| Rate for Payer: Global Benefits Group Commercial |
$1.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: Multiplan Commercial |
$1.72
|
| Rate for Payer: Networks By Design Commercial |
$1.50
|
| Rate for Payer: Prime Health Services Commercial |
$1.96
|
|
|
HC RTNR DRSNG TUBULAR SZ 6 25YDS
|
Facility
|
OP
|
$2.30
|
|
| Hospital Charge Code |
901698749
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$2.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.36
|
| Rate for Payer: Blue Distinction Transplant |
$1.38
|
| Rate for Payer: Blue Shield of California Commercial |
$1.45
|
| Rate for Payer: Blue Shield of California EPN |
$1.12
|
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Central Health Plan Commercial |
$1.84
|
| Rate for Payer: Cigna of CA HMO |
$1.47
|
| Rate for Payer: Cigna of CA PPO |
$1.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.96
|
| Rate for Payer: Dignity Health Media |
$1.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.92
|
| Rate for Payer: Galaxy Health WC |
$1.96
|
| Rate for Payer: Global Benefits Group Commercial |
$1.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: Multiplan Commercial |
$1.72
|
| Rate for Payer: Networks By Design Commercial |
$1.50
|
| Rate for Payer: Prime Health Services Commercial |
$1.96
|
| Rate for Payer: Riverside University Health System MISP |
$0.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.15
|
| Rate for Payer: United Healthcare All Other HMO |
$1.15
|
| Rate for Payer: United Healthcare HMO Rider |
$1.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.96
|
| Rate for Payer: Vantage Medical Group Senior |
$1.96
|
|
|
HC RTNR NET DRSNG TUBULAR SIZE 10
|
Facility
|
OP
|
$3.85
|
|
|
Service Code
|
CPT A6457
|
| Hospital Charge Code |
901698684
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.27
|
| Rate for Payer: Blue Distinction Transplant |
$2.31
|
| Rate for Payer: Blue Shield of California Commercial |
$2.42
|
| Rate for Payer: Blue Shield of California EPN |
$1.88
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: Cigna of CA HMO |
$2.46
|
| Rate for Payer: Cigna of CA PPO |
$2.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.27
|
| Rate for Payer: Dignity Health Media |
$3.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.27
|
| Rate for Payer: Vantage Medical Group Senior |
$3.27
|
|
|
HC RTNR NET DRSNG TUBULAR SIZE 10
|
Facility
|
IP
|
$3.85
|
|
|
Service Code
|
CPT A6457
|
| Hospital Charge Code |
901698684
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.27
|
| Rate for Payer: Global Benefits Group Commercial |
$2.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.89
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.27
|
|
|
HC RTNR NET DRSNG TUBULAR SZ 1
|
Facility
|
OP
|
$0.90
|
|
| Hospital Charge Code |
901698739
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.53
|
| Rate for Payer: Blue Distinction Transplant |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.57
|
| Rate for Payer: Blue Shield of California EPN |
$0.44
|
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: Central Health Plan Commercial |
$0.72
|
| Rate for Payer: Cigna of CA HMO |
$0.58
|
| Rate for Payer: Cigna of CA PPO |
$0.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.77
|
| Rate for Payer: Dignity Health Media |
$0.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.36
|
| Rate for Payer: Galaxy Health WC |
$0.77
|
| Rate for Payer: Global Benefits Group Commercial |
$0.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.81
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.68
|
| Rate for Payer: Networks By Design Commercial |
$0.59
|
| Rate for Payer: Prime Health Services Commercial |
$0.77
|
| Rate for Payer: Riverside University Health System MISP |
$0.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.45
|
| Rate for Payer: United Healthcare All Other HMO |
$0.45
|
| Rate for Payer: United Healthcare HMO Rider |
$0.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.77
|
| Rate for Payer: Vantage Medical Group Senior |
$0.77
|
|
|
HC RTNR NET DRSNG TUBULAR SZ 1
|
Facility
|
IP
|
$0.90
|
|
| Hospital Charge Code |
901698739
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: Central Health Plan Commercial |
$0.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.36
|
| Rate for Payer: Galaxy Health WC |
$0.77
|
| Rate for Payer: Global Benefits Group Commercial |
$0.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.68
|
| Rate for Payer: Networks By Design Commercial |
$0.59
|
| Rate for Payer: Prime Health Services Commercial |
$0.77
|
|
|
HC RTNR NET DRSNG TUBULAR SZ 10
|
Facility
|
IP
|
$4.43
|
|
| Hospital Charge Code |
901698747
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.99 |
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Central Health Plan Commercial |
$3.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$3.32
|
| Rate for Payer: Networks By Design Commercial |
$2.88
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
|
