|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
OP
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Adventist Health Commercial |
$8.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.15
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cigna of CA HMO |
$26.08
|
| Rate for Payer: Cigna of CA PPO |
$30.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.30
|
| Rate for Payer: EPIC Health Plan Senior |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$34.64
|
| Rate for Payer: Global Benefits Group Commercial |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.52
|
| Rate for Payer: Multiplan Commercial |
$32.60
|
| Rate for Payer: Networks By Design Commercial |
$26.49
|
| Rate for Payer: Prime Health Services Commercial |
$34.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.38
|
| Rate for Payer: United Healthcare All Other HMO |
$20.38
|
| Rate for Payer: United Healthcare HMO Rider |
$20.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.64
|
| Rate for Payer: Vantage Medical Group Senior |
$34.64
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
IP
|
$36.08
|
|
| Hospital Charge Code |
901698975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$30.67 |
| Rate for Payer: Adventist Health Commercial |
$7.22
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.43
|
| Rate for Payer: Galaxy Health WC |
$30.67
|
| Rate for Payer: Global Benefits Group Commercial |
$21.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.66
|
| Rate for Payer: Multiplan Commercial |
$28.86
|
| Rate for Payer: Networks By Design Commercial |
$23.45
|
| Rate for Payer: Prime Health Services Commercial |
$30.67
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
OP
|
$36.08
|
|
| Hospital Charge Code |
901698975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$30.67 |
| Rate for Payer: Adventist Health Commercial |
$7.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.15
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cigna of CA HMO |
$23.09
|
| Rate for Payer: Cigna of CA PPO |
$26.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.43
|
| Rate for Payer: Galaxy Health WC |
$30.67
|
| Rate for Payer: Global Benefits Group Commercial |
$21.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.26
|
| Rate for Payer: Multiplan Commercial |
$28.86
|
| Rate for Payer: Networks By Design Commercial |
$23.45
|
| Rate for Payer: Prime Health Services Commercial |
$30.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.04
|
| Rate for Payer: United Healthcare All Other HMO |
$18.04
|
| Rate for Payer: United Healthcare HMO Rider |
$18.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.67
|
| Rate for Payer: Vantage Medical Group Senior |
$30.67
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604281
|
|
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 7.0MM W/CUFF
|
Facility
|
IP
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Adventist Health Commercial |
$8.15
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.30
|
| Rate for Payer: EPIC Health Plan Senior |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$34.64
|
| Rate for Payer: Global Benefits Group Commercial |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$32.60
|
| Rate for Payer: Networks By Design Commercial |
$26.49
|
| Rate for Payer: Prime Health Services Commercial |
$34.64
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604281
|
|
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 |
$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 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 7.5MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604282
|
|
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 7.5MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604282
|
|
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 |
$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 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 8.0MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604283
|
|
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 8.0MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604283
|
|
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 |
$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 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 8.5MM W/CUFF
|
Facility
|
OP
|
$95.30
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Cigna of CA PPO |
$70.52
|
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.15
|
| Rate for Payer: Cash Price |
$42.88
|
| Rate for Payer: Cigna of CA HMO |
$60.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.12
|
| Rate for Payer: EPIC Health Plan Senior |
$38.12
|
| Rate for Payer: Galaxy Health WC |
$81.00
|
| Rate for Payer: Global Benefits Group Commercial |
$57.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.71
|
| Rate for Payer: Multiplan Commercial |
$76.24
|
| Rate for Payer: Networks By Design Commercial |
$61.95
|
| Rate for Payer: Prime Health Services Commercial |
$81.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.65
|
| Rate for Payer: United Healthcare All Other HMO |
$47.65
|
| Rate for Payer: United Healthcare HMO Rider |
$47.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.00
|
| Rate for Payer: Vantage Medical Group Senior |
$81.00
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
OP
|
$25.83
|
|
| Hospital Charge Code |
901698926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$21.96 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.58
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cigna of CA HMO |
$16.53
|
| Rate for Payer: Cigna of CA PPO |
$19.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.33
|
| Rate for Payer: EPIC Health Plan Senior |
$10.33
|
| Rate for Payer: Galaxy Health WC |
$21.96
|
| Rate for Payer: Global Benefits Group Commercial |
$15.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.08
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$16.79
|
| Rate for Payer: Prime Health Services Commercial |
$21.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.91
|
| Rate for Payer: United Healthcare All Other HMO |
$12.91
|
| Rate for Payer: United Healthcare HMO Rider |
$12.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.96
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604284
|
|
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 8.5MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604284
|
|
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 |
$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 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 8.5MM W/CUFF
|
Facility
|
IP
|
$25.83
|
|
| Hospital Charge Code |
901698926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$21.96 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.33
|
| Rate for Payer: EPIC Health Plan Senior |
$10.33
|
| Rate for Payer: Galaxy Health WC |
$21.96
|
| Rate for Payer: Global Benefits Group Commercial |
$15.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$16.79
|
| Rate for Payer: Prime Health Services Commercial |
$21.96
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
IP
|
$59.61
|
|
| Hospital Charge Code |
901698929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$50.67 |
| Rate for Payer: Adventist Health Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.84
|
| Rate for Payer: EPIC Health Plan Senior |
$23.84
|
| Rate for Payer: Galaxy Health WC |
$50.67
|
| Rate for Payer: Global Benefits Group Commercial |
$35.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.31
|
| Rate for Payer: Multiplan Commercial |
$47.69
|
| Rate for Payer: Networks By Design Commercial |
$38.75
|
| Rate for Payer: Prime Health Services Commercial |
$50.67
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
IP
|
$95.30
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Cash Price |
$42.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.12
|
| Rate for Payer: EPIC Health Plan Senior |
$38.12
|
| Rate for Payer: Galaxy Health WC |
$81.00
|
| Rate for Payer: Global Benefits Group Commercial |
$57.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.87
|
| Rate for Payer: Multiplan Commercial |
$76.24
|
| Rate for Payer: Networks By Design Commercial |
$61.95
|
| Rate for Payer: Prime Health Services Commercial |
$81.00
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
IP
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$13.24 |
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.23
|
| Rate for Payer: EPIC Health Plan Senior |
$6.23
|
| Rate for Payer: Galaxy Health WC |
$13.24
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: Multiplan Commercial |
$12.46
|
| Rate for Payer: Networks By Design Commercial |
$10.13
|
| Rate for Payer: Prime Health Services Commercial |
$13.24
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
OP
|
$59.61
|
|
| Hospital Charge Code |
901698929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$50.67 |
| Rate for Payer: Adventist Health Commercial |
$11.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.25
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Cigna of CA HMO |
$38.15
|
| Rate for Payer: Cigna of CA PPO |
$44.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.84
|
| Rate for Payer: EPIC Health Plan Senior |
$23.84
|
| Rate for Payer: Galaxy Health WC |
$50.67
|
| Rate for Payer: Global Benefits Group Commercial |
$35.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.73
|
| Rate for Payer: Multiplan Commercial |
$47.69
|
| Rate for Payer: Networks By Design Commercial |
$38.75
|
| Rate for Payer: Prime Health Services Commercial |
$50.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.80
|
| Rate for Payer: United Healthcare All Other HMO |
$29.80
|
| Rate for Payer: United Healthcare HMO Rider |
$29.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.67
|
| Rate for Payer: Vantage Medical Group Senior |
$50.67
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
OP
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$13.24 |
| Rate for Payer: United Healthcare HMO Rider |
$7.79
|
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.00
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Cigna of CA HMO |
$9.97
|
| Rate for Payer: Cigna of CA PPO |
$11.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.23
|
| Rate for Payer: EPIC Health Plan Senior |
$6.23
|
| Rate for Payer: Galaxy Health WC |
$13.24
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$12.46
|
| Rate for Payer: Networks By Design Commercial |
$10.13
|
| Rate for Payer: Prime Health Services Commercial |
$13.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.79
|
| Rate for Payer: United Healthcare All Other HMO |
$7.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.24
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC TUBE ENDOTRACH 9.0MM W/CUFF
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604285
|
|
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 9.0MM W/CUFF
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604285
|
|
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 |
$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 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 9MM W/CUFF
|
Facility
|
OP
|
$28.78
|
|
| Hospital Charge Code |
901698710
|
|
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 |
$18.47
|
| Rate for Payer: Cash Price |
$12.95
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.15
|
| 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 Foundation Hospitals Commercial/Self Funded |
$18.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.98
|
| 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 9MM W/CUFF
|
Facility
|
IP
|
$28.78
|
|
| Hospital Charge Code |
901698710
|
|
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 |
$12.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.15
|
| 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 Foundation Hospitals Commercial/Self Funded |
$18.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.98
|
| 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 FSTNR 5.0-8.0MM
|
Facility
|
IP
|
$81.26
|
|
| Hospital Charge Code |
901698364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$69.07 |
| Rate for Payer: Adventist Health Commercial |
$16.25
|
| Rate for Payer: Cash Price |
$36.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Senior |
$32.50
|
| Rate for Payer: Galaxy Health WC |
$69.07
|
| Rate for Payer: Global Benefits Group Commercial |
$48.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.50
|
| Rate for Payer: Multiplan Commercial |
$65.01
|
| Rate for Payer: Networks By Design Commercial |
$52.82
|
| Rate for Payer: Prime Health Services Commercial |
$69.07
|
|
