|
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 |
$12.11 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.17
|
| 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 Exchange |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.82
|
| Rate for Payer: Blue Shield of California Commercial |
$8.53
|
| Rate for Payer: Blue Shield of California EPN |
$5.37
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.41
|
| 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: Health Management Network EPO/PPO |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.41
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.38
|
| 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 |
$12.11 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.41
|
| 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: Health Management Network EPO/PPO |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| 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
|
$14.76
|
|
| Hospital Charge Code |
901698797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$13.28 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.59
|
| Rate for Payer: Blue Shield of California Commercial |
$9.36
|
| Rate for Payer: Blue Shield of California EPN |
$5.89
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.81
|
| Rate for Payer: Cigna of CA HMO |
$9.45
|
| Rate for Payer: Cigna of CA PPO |
$10.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$11.07
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
| Rate for Payer: Riverside University Health System MISP |
$5.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.38
|
| Rate for Payer: United Healthcare All Other HMO |
$7.38
|
| Rate for Payer: United Healthcare HMO Rider |
$7.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.55
|
| Rate for Payer: Vantage Medical Group Senior |
$12.55
|
|
|
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 |
$39.55 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Central Health Plan Commercial |
$35.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.77
|
| 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: Health Management Network EPO/PPO |
$39.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.79
|
| Rate for Payer: Multiplan Commercial |
$32.96
|
| Rate for Payer: Networks By Design Commercial |
$28.57
|
| Rate for Payer: Prime Health Services Commercial |
$37.36
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
OP
|
$30.18
|
|
| Hospital Charge Code |
901698941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$27.16 |
| Rate for Payer: Adventist Health Commercial |
$6.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.56
|
| Rate for Payer: Blue Shield of California Commercial |
$19.13
|
| Rate for Payer: Blue Shield of California EPN |
$12.04
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Central Health Plan Commercial |
$24.14
|
| Rate for Payer: Cigna of CA HMO |
$19.32
|
| Rate for Payer: Cigna of CA PPO |
$22.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.07
|
| Rate for Payer: EPIC Health Plan Senior |
$12.07
|
| Rate for Payer: Galaxy Health WC |
$25.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.13
|
| Rate for Payer: Multiplan Commercial |
$22.64
|
| Rate for Payer: Networks By Design Commercial |
$19.62
|
| Rate for Payer: Prime Health Services Commercial |
$25.65
|
| Rate for Payer: Riverside University Health System MISP |
$12.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.09
|
| Rate for Payer: United Healthcare All Other HMO |
$15.09
|
| Rate for Payer: United Healthcare HMO Rider |
$15.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.65
|
| Rate for Payer: Vantage Medical Group Senior |
$25.65
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
IP
|
$14.76
|
|
| Hospital Charge Code |
901698797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$13.28 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: EPIC Health Plan Senior |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Multiplan Commercial |
$11.07
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.55
|
|
|
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 |
$39.55 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.69
|
| 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 Exchange |
$21.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.57
|
| Rate for Payer: Blue Shield of California Commercial |
$27.86
|
| Rate for Payer: Blue Shield of California EPN |
$17.54
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Central Health Plan Commercial |
$35.16
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.77
|
| 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: Health Management Network EPO/PPO |
$39.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$30.77
|
| Rate for Payer: Multiplan Commercial |
$32.96
|
| Rate for Payer: Networks By Design Commercial |
$28.57
|
| Rate for Payer: Prime Health Services Commercial |
$37.36
|
| Rate for Payer: Riverside University Health System MISP |
$17.58
|
| 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
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.50
|
| 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 Exchange |
$9.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.97
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$8.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| 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 6.0MM W/CUFF
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
IP
|
$30.18
|
|
| Hospital Charge Code |
901698941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$27.16 |
| Rate for Payer: Adventist Health Commercial |
$6.04
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Central Health Plan Commercial |
$24.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.07
|
| Rate for Payer: EPIC Health Plan Senior |
$12.07
|
| Rate for Payer: Galaxy Health WC |
$25.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.04
|
| Rate for Payer: Multiplan Commercial |
$22.64
|
| Rate for Payer: Networks By Design Commercial |
$19.62
|
| Rate for Payer: Prime Health Services Commercial |
$25.65
|
|
|
HC TUBE ENDOTRACH 6.0 STYLET CUFF
|
Facility
|
OP
|
$30.50
|
|
| Hospital Charge Code |
901698962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.74
|
| Rate for Payer: Blue Shield of California Commercial |
$19.34
|
| Rate for Payer: Blue Shield of California EPN |
$12.17
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.35
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
| Rate for Payer: Riverside University Health System MISP |
$12.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$25.93
|
|
|
HC TUBE ENDOTRACH 6.0 STYLET CUFF
|
Facility
|
IP
|
$30.50
|
|
| Hospital Charge Code |
901698962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
|
|
HC TUBE ENDOTRACH 6.5MM W/CUFF
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
|
|
HC TUBE ENDOTRACH 6.5MM W/CUFF
|
Facility
|
OP
|
$31.16
|
|
| Hospital Charge Code |
901698788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Adventist Health Commercial |
$6.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.13
|
| Rate for Payer: Blue Shield of California Commercial |
$19.76
|
| Rate for Payer: Blue Shield of California EPN |
$12.43
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: Cigna of CA HMO |
$19.94
|
| Rate for Payer: Cigna of CA PPO |
$23.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Senior |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.81
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
| Rate for Payer: Riverside University Health System MISP |
$12.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.58
|
| Rate for Payer: United Healthcare All Other HMO |
$15.58
|
| Rate for Payer: United Healthcare HMO Rider |
$15.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$26.49
|
|
|
HC TUBE ENDOTRACH 6.5MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.50
|
| 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 Exchange |
$9.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.97
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$8.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| 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 6.5MM W/CUFF
|
Facility
|
IP
|
$31.16
|
|
| Hospital Charge Code |
901698788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Adventist Health Commercial |
$6.23
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Senior |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
|
|
HC TUBE ENDOTRACH 6.5MM W/CUFF
|
Facility
|
OP
|
$28.70
|
|
| Hospital Charge Code |
901698938
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.74 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Adventist Health Commercial |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.69
|
| Rate for Payer: Blue Shield of California Commercial |
$18.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.45
|
| Rate for Payer: Cash Price |
$12.92
|
| Rate for Payer: Central Health Plan Commercial |
$22.96
|
| Rate for Payer: Cigna of CA HMO |
$18.37
|
| Rate for Payer: Cigna of CA PPO |
$21.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.48
|
| Rate for Payer: EPIC Health Plan Senior |
$11.48
|
| Rate for Payer: Galaxy Health WC |
$24.39
|
| Rate for Payer: Global Benefits Group Commercial |
$17.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.09
|
| Rate for Payer: Multiplan Commercial |
$21.52
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$24.39
|
| Rate for Payer: Riverside University Health System MISP |
$11.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.35
|
| Rate for Payer: United Healthcare All Other HMO |
$14.35
|
| Rate for Payer: United Healthcare HMO Rider |
$14.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: Vantage Medical Group Senior |
$24.39
|
|
|
HC TUBE ENDOTRACH 6.5MM W/CUFF
|
Facility
|
IP
|
$28.70
|
|
| Hospital Charge Code |
901698938
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.74 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Adventist Health Commercial |
$5.74
|
| Rate for Payer: Cash Price |
$12.92
|
| Rate for Payer: Central Health Plan Commercial |
$22.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.48
|
| Rate for Payer: EPIC Health Plan Senior |
$11.48
|
| Rate for Payer: Galaxy Health WC |
$24.39
|
| Rate for Payer: Global Benefits Group Commercial |
$17.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.74
|
| Rate for Payer: Multiplan Commercial |
$21.52
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$24.39
|
|
|
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 |
$32.47 |
| Rate for Payer: Adventist Health Commercial |
$7.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.91
|
| 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 Exchange |
$17.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.99
|
| Rate for Payer: Blue Shield of California Commercial |
$22.87
|
| Rate for Payer: Blue Shield of California EPN |
$14.40
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Central Health Plan Commercial |
$28.86
|
| 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: Health Management Network EPO/PPO |
$32.47
|
| 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 |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.26
|
| Rate for Payer: Multiplan Commercial |
$27.06
|
| Rate for Payer: Networks By Design Commercial |
$23.45
|
| Rate for Payer: Prime Health Services Commercial |
$30.67
|
| Rate for Payer: Riverside University Health System MISP |
$14.43
|
| 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
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$36.67 |
| Rate for Payer: Adventist Health Commercial |
$8.15
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Central Health Plan Commercial |
$32.60
|
| 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: Health Management Network EPO/PPO |
$36.67
|
| 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 |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$30.56
|
| 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
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604281
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.50
|
| 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 Exchange |
$9.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.97
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$8.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| 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 7.0MM W/CUFF
|
Facility
|
IP
|
$36.08
|
|
| Hospital Charge Code |
901698975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Adventist Health Commercial |
$7.22
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Central Health Plan Commercial |
$28.86
|
| 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: Health Management Network EPO/PPO |
$32.47
|
| 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 |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$27.06
|
| 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
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$36.67 |
| Rate for Payer: Adventist Health Commercial |
$8.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.75
|
| 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 Exchange |
$19.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.70
|
| Rate for Payer: Blue Shield of California Commercial |
$25.84
|
| Rate for Payer: Blue Shield of California EPN |
$16.26
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Central Health Plan Commercial |
$32.60
|
| 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: Health Management Network EPO/PPO |
$36.67
|
| 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 |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.52
|
| Rate for Payer: Multiplan Commercial |
$30.56
|
| Rate for Payer: Networks By Design Commercial |
$26.49
|
| Rate for Payer: Prime Health Services Commercial |
$34.64
|
| Rate for Payer: Riverside University Health System MISP |
$16.30
|
| 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 7.5MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604282
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Adventist Health Commercial |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.50
|
| 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 Exchange |
$9.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.97
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$8.21
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Central Health Plan Commercial |
$16.46
|
| 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: Health Management Network EPO/PPO |
$18.52
|
| 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 |
$4.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.41
|
| Rate for Payer: Multiplan Commercial |
$15.44
|
| Rate for Payer: Networks By Design Commercial |
$13.38
|
| Rate for Payer: Prime Health Services Commercial |
$17.49
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| 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
|
|
