|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$15.42
|
|
| Hospital Charge Code |
901698584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.90
|
| Rate for Payer: Cash Price |
$6.94
|
| Rate for Payer: Cigna of CA HMO |
$9.87
|
| Rate for Payer: Cigna of CA PPO |
$11.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
| Rate for Payer: EPIC Health Plan Senior |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$13.11
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.79
|
| Rate for Payer: Multiplan Commercial |
$12.34
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.71
|
| Rate for Payer: United Healthcare All Other HMO |
$7.71
|
| Rate for Payer: United Healthcare HMO Rider |
$7.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.11
|
| Rate for Payer: Vantage Medical Group Senior |
$13.11
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$32.64
|
|
| Hospital Charge Code |
901698934
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$27.74 |
| Rate for Payer: Adventist Health Commercial |
$6.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.95
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cigna of CA HMO |
$20.89
|
| Rate for Payer: Cigna of CA PPO |
$24.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Senior |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.85
|
| Rate for Payer: Multiplan Commercial |
$26.11
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.32
|
| Rate for Payer: United Healthcare All Other HMO |
$16.32
|
| Rate for Payer: United Healthcare HMO Rider |
$16.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.74
|
| Rate for Payer: Vantage Medical Group Senior |
$27.74
|
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607701
|
|
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 |
$9.11
|
| Rate for Payer: Cash Price |
$6.39
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 2.5MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607701
|
|
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 |
$6.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 2.5MM UNCUFF
|
Facility
|
IP
|
$32.64
|
|
| Hospital Charge Code |
901698934
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$27.74 |
| Rate for Payer: Adventist Health Commercial |
$6.53
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Senior |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.83
|
| Rate for Payer: Multiplan Commercial |
$26.11
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
IP
|
$56.74
|
|
| Hospital Charge Code |
901698930
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$48.23 |
| Rate for Payer: Adventist Health Commercial |
$11.35
|
| Rate for Payer: Cash Price |
$25.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.70
|
| Rate for Payer: EPIC Health Plan Senior |
$22.70
|
| Rate for Payer: Galaxy Health WC |
$48.23
|
| Rate for Payer: Global Benefits Group Commercial |
$34.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.62
|
| Rate for Payer: Multiplan Commercial |
$45.39
|
| Rate for Payer: Networks By Design Commercial |
$36.88
|
| Rate for Payer: Prime Health Services Commercial |
$48.23
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607702
|
|
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 |
$6.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 3.0MM UNCUFF
|
Facility
|
IP
|
$37.80
|
|
| Hospital Charge Code |
901698939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Adventist Health Commercial |
$7.56
|
| Rate for Payer: Cash Price |
$17.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.12
|
| Rate for Payer: EPIC Health Plan Senior |
$15.12
|
| Rate for Payer: Galaxy Health WC |
$32.13
|
| Rate for Payer: Global Benefits Group Commercial |
$22.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.07
|
| Rate for Payer: Multiplan Commercial |
$30.24
|
| Rate for Payer: Networks By Design Commercial |
$24.57
|
| Rate for Payer: Prime Health Services Commercial |
$32.13
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
OP
|
$56.74
|
|
| Hospital Charge Code |
901698930
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$48.23 |
| Rate for Payer: Adventist Health Commercial |
$11.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.41
|
| Rate for Payer: Cash Price |
$25.53
|
| Rate for Payer: Cigna of CA HMO |
$36.31
|
| Rate for Payer: Cigna of CA PPO |
$41.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.70
|
| Rate for Payer: EPIC Health Plan Senior |
$22.70
|
| Rate for Payer: Galaxy Health WC |
$48.23
|
| Rate for Payer: Global Benefits Group Commercial |
$34.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.72
|
| Rate for Payer: Multiplan Commercial |
$45.39
|
| Rate for Payer: Networks By Design Commercial |
$36.88
|
| Rate for Payer: Prime Health Services Commercial |
$48.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.37
|
| Rate for Payer: United Healthcare All Other HMO |
$28.37
|
| Rate for Payer: United Healthcare HMO Rider |
$28.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.23
|
| Rate for Payer: Vantage Medical Group Senior |
$48.23
|
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607702
|
|
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 |
$9.11
|
| Rate for Payer: Cash Price |
$6.39
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 3.0MM UNCUFF
|
Facility
|
OP
|
$37.80
|
|
| Hospital Charge Code |
901698939
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Adventist Health Commercial |
$7.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.26
|
| Rate for Payer: Cash Price |
$17.01
|
| Rate for Payer: Cigna of CA HMO |
$24.19
|
| Rate for Payer: Cigna of CA PPO |
$27.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.12
|
| Rate for Payer: EPIC Health Plan Senior |
$15.12
|
| Rate for Payer: Galaxy Health WC |
$32.13
|
| Rate for Payer: Global Benefits Group Commercial |
$22.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.46
|
| Rate for Payer: Multiplan Commercial |
$30.24
|
| Rate for Payer: Networks By Design Commercial |
$24.57
|
| Rate for Payer: Prime Health Services Commercial |
$32.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.90
|
| Rate for Payer: United Healthcare All Other HMO |
$18.90
|
| Rate for Payer: United Healthcare HMO Rider |
$18.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.13
|
| Rate for Payer: Vantage Medical Group Senior |
$32.13
|
|
|
HC TUBE ENDOTRACH 3.0MM W/CUFF
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901698731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC TUBE ENDOTRACH 3.0MM W/CUFF
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901698731
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC TUBE ENDOTRACH 3.5MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607703
|
|
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 |
$9.11
|
| Rate for Payer: Cash Price |
$6.39
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 3.5MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607703
|
|
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 |
$6.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 3.5MM W/CUFF
|
Facility
|
OP
|
$14.68
|
|
| Hospital Charge Code |
901698732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.42
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Cigna of CA HMO |
$9.40
|
| Rate for Payer: Cigna of CA PPO |
$10.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$11.74
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.34
|
| Rate for Payer: United Healthcare All Other HMO |
$7.34
|
| Rate for Payer: United Healthcare HMO Rider |
$7.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.48
|
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604957
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| 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 |
$13.26
|
| Rate for Payer: Cash Price |
$9.30
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.46
|
| 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 Foundation Hospitals Commercial/Self Funded |
$13.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.19
|
| 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 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 3.5MM W/CUFF
|
Facility
|
IP
|
$14.68
|
|
| Hospital Charge Code |
901698732
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Cash Price |
$6.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$12.48
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.52
|
| Rate for Payer: Multiplan Commercial |
$11.74
|
| Rate for Payer: Networks By Design Commercial |
$9.54
|
| Rate for Payer: Prime Health Services Commercial |
$12.48
|
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604957
|
|
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 |
$9.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.46
|
| 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 Foundation Hospitals Commercial/Self Funded |
$13.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.19
|
| 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 3.OMM W/CUFF
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604914
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$17.49 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$17.49
|
| Rate for Payer: Global Benefits Group Commercial |
$12.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$16.46
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
|
|
HC TUBE ENDOTRACH 3.OMM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604914
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$17.49 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Cigna of CA HMO |
$13.17
|
| Rate for Payer: Cigna of CA PPO |
$15.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$17.49
|
| Rate for Payer: Global Benefits Group Commercial |
$12.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$16.46
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.29
|
| Rate for Payer: United Healthcare All Other HMO |
$10.29
|
| Rate for Payer: United Healthcare HMO Rider |
$10.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.49
|
| Rate for Payer: Vantage Medical Group Senior |
$17.49
|
|
|
HC TUBE ENDOTRACH 4.0MM UNCUFF
|
Facility
|
IP
|
$14.19
|
|
| Hospital Charge Code |
901607704
|
|
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 |
$6.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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 4.0MM UNCUFF
|
Facility
|
OP
|
$14.19
|
|
| Hospital Charge Code |
901607704
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$12.06 |
| Rate for Payer: Vantage Medical Group Senior |
$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 |
$9.11
|
| Rate for Payer: Cash Price |
$6.39
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.93
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.37
|
| 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
|
|
|
HC TUBE ENDOTRACH 4.0MM UNCUFF
|
Facility
|
IP
|
$9.59
|
|
| Hospital Charge Code |
901698844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$8.15 |
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| Rate for Payer: Cash Price |
$4.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: Galaxy Health WC |
$8.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.30
|
| Rate for Payer: Multiplan Commercial |
$7.67
|
| Rate for Payer: Networks By Design Commercial |
$6.23
|
| Rate for Payer: Prime Health Services Commercial |
$8.15
|
|
|
HC TUBE ENDOTRACH 4.0MM UNCUFF
|
Facility
|
IP
|
$32.64
|
|
| Hospital Charge Code |
901698931
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$27.74 |
| Rate for Payer: Adventist Health Commercial |
$6.53
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.06
|
| Rate for Payer: EPIC Health Plan Senior |
$13.06
|
| Rate for Payer: Galaxy Health WC |
$27.74
|
| Rate for Payer: Global Benefits Group Commercial |
$19.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.83
|
| Rate for Payer: Multiplan Commercial |
$26.11
|
| Rate for Payer: Networks By Design Commercial |
$21.22
|
| Rate for Payer: Prime Health Services Commercial |
$27.74
|
|
