|
HC TUBE ENDOTRACH 4.5 CUFFED
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604956
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.69
|
| Rate for Payer: Cash Price |
$11.36
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC TUBE ENDOTRACH 4.5MM NO CUFF
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
913200744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Adventist Health Commercial |
$1.84
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Senior |
$3.67
|
| Rate for Payer: Galaxy Health WC |
$7.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Multiplan Commercial |
$7.34
|
| Rate for Payer: Networks By Design Commercial |
$5.97
|
| Rate for Payer: Prime Health Services Commercial |
$7.80
|
|
|
HC TUBE ENDOTRACH 4.5MM NO CUFF
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
913200744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Adventist Health Commercial |
$1.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.64
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Cigna of CA HMO |
$5.88
|
| Rate for Payer: Cigna of CA PPO |
$6.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Senior |
$3.67
|
| Rate for Payer: Galaxy Health WC |
$7.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.43
|
| Rate for Payer: Multiplan Commercial |
$7.34
|
| Rate for Payer: Networks By Design Commercial |
$5.97
|
| Rate for Payer: Prime Health Services Commercial |
$7.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.59
|
| Rate for Payer: United Healthcare All Other HMO |
$4.59
|
| Rate for Payer: United Healthcare HMO Rider |
$4.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7.80
|
|
|
HC TUBE ENDOTRACH 4.5MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.06 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.71
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cigna of CA HMO |
$9.08
|
| Rate for Payer: Cigna of CA PPO |
$10.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.93
|
| Rate for Payer: Multiplan Commercial |
$11.35
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.09
|
| Rate for Payer: United Healthcare All Other HMO |
$7.09
|
| Rate for Payer: United Healthcare HMO Rider |
$7.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.06
|
| Rate for Payer: Vantage Medical Group Senior |
$12.06
|
|
|
HC TUBE ENDOTRACH 4.5MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.06 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$11.35
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
|
|
HC TUBE ENDOTRACH 5.0MM NO CUFF
|
Facility
|
OP
|
$9.51
|
|
| Hospital Charge Code |
901604277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.84
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Cigna of CA HMO |
$6.09
|
| Rate for Payer: Cigna of CA PPO |
$7.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$8.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$7.61
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$8.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO |
$4.75
|
| Rate for Payer: United Healthcare HMO Rider |
$4.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC TUBE ENDOTRACH 5.0MM NO CUFF
|
Facility
|
IP
|
$9.51
|
|
| Hospital Charge Code |
901604277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$8.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.28
|
| Rate for Payer: Multiplan Commercial |
$7.61
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$8.08
|
|
|
HC TUBE ENDOTRACH 5.0MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604916
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.69
|
| Rate for Payer: Cash Price |
$11.36
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC TUBE ENDOTRACH 5.0MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604916
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Cash Price |
$11.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
OP
|
$8.94
|
|
| Hospital Charge Code |
901698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$7.60 |
| Rate for Payer: Adventist Health Commercial |
$1.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.49
|
| Rate for Payer: Cash Price |
$4.92
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Senior |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.26
|
| Rate for Payer: Multiplan Commercial |
$7.15
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.06 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.71
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cigna of CA HMO |
$9.08
|
| Rate for Payer: Cigna of CA PPO |
$10.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.93
|
| Rate for Payer: Multiplan Commercial |
$11.35
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.09
|
| Rate for Payer: United Healthcare All Other HMO |
$7.09
|
| Rate for Payer: United Healthcare HMO Rider |
$7.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.06
|
| Rate for Payer: Vantage Medical Group Senior |
$12.06
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607706
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.06 |
| Rate for Payer: Adventist Health Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.68
|
| Rate for Payer: EPIC Health Plan Senior |
$5.68
|
| Rate for Payer: Galaxy Health WC |
$12.06
|
| Rate for Payer: Global Benefits Group Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$11.35
|
| Rate for Payer: Networks By Design Commercial |
$9.22
|
| Rate for Payer: Prime Health Services Commercial |
$12.06
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
IP
|
$8.94
|
|
| Hospital Charge Code |
901698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$7.60 |
| Rate for Payer: Adventist Health Commercial |
$1.79
|
| Rate for Payer: Cash Price |
$4.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Senior |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.15
|
| Rate for Payer: Multiplan Commercial |
$7.15
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
OP
|
$11.97
|
|
| Hospital Charge Code |
901698575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Adventist Health Commercial |
$2.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.35
|
| Rate for Payer: Cash Price |
$6.58
|
| Rate for Payer: Cigna of CA HMO |
$7.66
|
| Rate for Payer: Cigna of CA PPO |
$8.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.38
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.99
|
| Rate for Payer: United Healthcare All Other HMO |
$5.99
|
| Rate for Payer: United Healthcare HMO Rider |
$5.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.17
|
| Rate for Payer: Vantage Medical Group Senior |
$10.17
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
OP
|
$28.78
|
|
| Hospital Charge Code |
901698887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Adventist Health Commercial |
$5.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.67
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: Cigna of CA HMO |
$18.42
|
| Rate for Payer: Cigna of CA PPO |
$21.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.51
|
| Rate for Payer: EPIC Health Plan Senior |
$11.51
|
| Rate for Payer: Galaxy Health WC |
$24.46
|
| Rate for Payer: Global Benefits Group Commercial |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.15
|
| Rate for Payer: Multiplan Commercial |
$23.02
|
| Rate for Payer: Networks By Design Commercial |
$18.71
|
| Rate for Payer: Prime Health Services Commercial |
$24.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.39
|
| Rate for Payer: United Healthcare All Other HMO |
$14.39
|
| Rate for Payer: United Healthcare HMO Rider |
$14.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.46
|
| Rate for Payer: Vantage Medical Group Senior |
$24.46
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
IP
|
$28.78
|
|
| Hospital Charge Code |
901698887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Adventist Health Commercial |
$5.76
|
| Rate for Payer: Cash Price |
$15.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.51
|
| Rate for Payer: EPIC Health Plan Senior |
$11.51
|
| Rate for Payer: Galaxy Health WC |
$24.46
|
| Rate for Payer: Global Benefits Group Commercial |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.91
|
| Rate for Payer: Multiplan Commercial |
$23.02
|
| Rate for Payer: Networks By Design Commercial |
$18.71
|
| Rate for Payer: Prime Health Services Commercial |
$24.46
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
OP
|
$36.82
|
|
| Hospital Charge Code |
901698781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.61
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO |
$23.56
|
| Rate for Payer: Cigna of CA PPO |
$27.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.77
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.41
|
| Rate for Payer: United Healthcare All Other HMO |
$18.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.30
|
| Rate for Payer: Vantage Medical Group Senior |
$31.30
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
IP
|
$11.97
|
|
| Hospital Charge Code |
901698575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Adventist Health Commercial |
$2.39
|
| Rate for Payer: Cash Price |
$6.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.87
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
IP
|
$36.82
|
|
| Hospital Charge Code |
901698781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
|
|
HC TUBE ENDOTRACH 5.5 W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901602990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Cash Price |
$11.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
|
|
HC TUBE ENDOTRACH 5.5 W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901602990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.69
|
| Rate for Payer: Cash Price |
$11.36
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC TUBE ENDOTRACH 6.0MM UNCUFF
|
Facility
|
OP
|
$13.45
|
|
| Hospital Charge Code |
901607707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$11.43 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.26
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: Cigna of CA HMO |
$8.61
|
| Rate for Payer: Cigna of CA PPO |
$9.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.41
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.72
|
| Rate for Payer: United Healthcare All Other HMO |
$6.72
|
| Rate for Payer: United Healthcare HMO Rider |
$6.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC TUBE ENDOTRACH 6.0MM UNCUFF
|
Facility
|
IP
|
$13.45
|
|
| Hospital Charge Code |
901607707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$11.43 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
OP
|
$43.95
|
|
| Hospital Charge Code |
901698722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.99
|
| Rate for Payer: Cash Price |
$24.17
|
| Rate for Payer: Cigna of CA HMO |
$28.13
|
| Rate for Payer: Cigna of CA PPO |
$32.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.58
|
| Rate for Payer: EPIC Health Plan Senior |
$17.58
|
| Rate for Payer: Galaxy Health WC |
$37.36
|
| Rate for Payer: Global Benefits Group Commercial |
$26.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.77
|
| Rate for Payer: Multiplan Commercial |
$35.16
|
| Rate for Payer: Networks By Design Commercial |
$28.57
|
| Rate for Payer: Prime Health Services Commercial |
$37.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.98
|
| Rate for Payer: United Healthcare All Other HMO |
$21.98
|
| Rate for Payer: United Healthcare HMO Rider |
$21.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.36
|
| Rate for Payer: Vantage Medical Group Senior |
$37.36
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
IP
|
$43.95
|
|
| Hospital Charge Code |
901698722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Cash Price |
$24.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.58
|
| Rate for Payer: EPIC Health Plan Senior |
$17.58
|
| Rate for Payer: Galaxy Health WC |
$37.36
|
| Rate for Payer: Global Benefits Group Commercial |
$26.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.55
|
| Rate for Payer: Multiplan Commercial |
$35.16
|
| Rate for Payer: Networks By Design Commercial |
$28.57
|
| Rate for Payer: Prime Health Services Commercial |
$37.36
|
|
