|
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
|
|
|
HC TUBE ENDOTRACH 8.0MM W/CUFF
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604283
|
|
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 8.0MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604283
|
|
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 8.5MM W/CUFF
|
Facility
|
IP
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Central Health Plan Commercial |
$12.46
|
| 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: Health Management Network EPO/PPO |
$14.02
|
| 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 |
$3.12
|
| Rate for Payer: Multiplan Commercial |
$11.69
|
| 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
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.46
|
| 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 Exchange |
$7.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$9.88
|
| Rate for Payer: Blue Shield of California EPN |
$6.22
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Central Health Plan Commercial |
$12.46
|
| 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: Health Management Network EPO/PPO |
$14.02
|
| 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 |
$3.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$11.69
|
| Rate for Payer: Networks By Design Commercial |
$10.13
|
| Rate for Payer: Prime Health Services Commercial |
$13.24
|
| Rate for Payer: Riverside University Health System MISP |
$6.23
|
| 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 HMO Rider |
$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 8.5MM W/CUFF
|
Facility
|
IP
|
$95.08
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.02 |
| Max. Negotiated Rate |
$85.57 |
| Rate for Payer: Adventist Health Commercial |
$19.02
|
| Rate for Payer: Cash Price |
$42.79
|
| Rate for Payer: Central Health Plan Commercial |
$76.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.03
|
| Rate for Payer: EPIC Health Plan Senior |
$38.03
|
| Rate for Payer: Galaxy Health WC |
$80.82
|
| Rate for Payer: Global Benefits Group Commercial |
$57.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.02
|
| Rate for Payer: Multiplan Commercial |
$71.31
|
| Rate for Payer: Networks By Design Commercial |
$61.80
|
| Rate for Payer: Prime Health Services Commercial |
$80.82
|
|
|
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 |
$23.25 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Central Health Plan Commercial |
$20.66
|
| 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: Health Management Network EPO/PPO |
$23.25
|
| 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 |
$5.17
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
| 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 |
$53.65 |
| Rate for Payer: Adventist Health Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Central Health Plan Commercial |
$47.69
|
| 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: Health Management Network EPO/PPO |
$53.65
|
| 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 |
$11.92
|
| Rate for Payer: Multiplan Commercial |
$44.71
|
| 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
|
OP
|
$59.61
|
|
| Hospital Charge Code |
901698929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$53.65 |
| Rate for Payer: Adventist Health Commercial |
$11.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.20
|
| 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 Exchange |
$28.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.68
|
| Rate for Payer: Blue Shield of California Commercial |
$37.79
|
| Rate for Payer: Blue Shield of California EPN |
$23.78
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Central Health Plan Commercial |
$47.69
|
| 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: Health Management Network EPO/PPO |
$53.65
|
| 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 |
$11.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$41.73
|
| Rate for Payer: Multiplan Commercial |
$44.71
|
| Rate for Payer: Networks By Design Commercial |
$38.75
|
| Rate for Payer: Prime Health Services Commercial |
$50.67
|
| Rate for Payer: Riverside University Health System MISP |
$23.84
|
| 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
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604284
|
|
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 8.5MM W/CUFF
|
Facility
|
OP
|
$25.83
|
|
| Hospital Charge Code |
901698926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.69
|
| 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 Exchange |
$12.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.03
|
| Rate for Payer: Blue Shield of California Commercial |
$16.38
|
| Rate for Payer: Blue Shield of California EPN |
$10.31
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Central Health Plan Commercial |
$20.66
|
| 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: Health Management Network EPO/PPO |
$23.25
|
| 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 |
$5.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.08
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
| Rate for Payer: Networks By Design Commercial |
$16.79
|
| Rate for Payer: Prime Health Services Commercial |
$21.96
|
| Rate for Payer: Riverside University Health System MISP |
$10.33
|
| 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
|
OP
|
$95.08
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.02 |
| Max. Negotiated Rate |
$85.57 |
| Rate for Payer: Adventist Health Commercial |
$19.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.31
|
| Rate for Payer: Blue Shield of California Commercial |
$60.28
|
| Rate for Payer: Blue Shield of California EPN |
$37.94
|
| Rate for Payer: Cash Price |
$42.79
|
| Rate for Payer: Central Health Plan Commercial |
$76.06
|
| Rate for Payer: Cigna of CA HMO |
$60.85
|
| Rate for Payer: Cigna of CA PPO |
$70.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$80.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.03
|
| Rate for Payer: EPIC Health Plan Senior |
$38.03
|
| Rate for Payer: Galaxy Health WC |
$80.82
|
| Rate for Payer: Global Benefits Group Commercial |
$57.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$66.56
|
| Rate for Payer: Multiplan Commercial |
$71.31
|
| Rate for Payer: Networks By Design Commercial |
$61.80
|
| Rate for Payer: Prime Health Services Commercial |
$80.82
|
| Rate for Payer: Riverside University Health System MISP |
$38.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.54
|
| Rate for Payer: United Healthcare All Other HMO |
$47.54
|
| Rate for Payer: United Healthcare HMO Rider |
$47.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$80.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.82
|
| Rate for Payer: Vantage Medical Group Senior |
$80.82
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604284
|
|
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 9.0MM W/CUFF
|
Facility
|
OP
|
$20.58
|
|
| Hospital Charge Code |
901604285
|
|
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 9.0MM W/CUFF
|
Facility
|
IP
|
$20.58
|
|
| Hospital Charge Code |
901604285
|
|
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 9MM W/CUFF
|
Facility
|
OP
|
$28.70
|
|
| Hospital Charge Code |
901698710
|
|
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 9MM W/CUFF
|
Facility
|
IP
|
$28.70
|
|
| Hospital Charge Code |
901698710
|
|
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 FSTNR 5.0-8.0MM
|
Facility
|
IP
|
$81.02
|
|
| Hospital Charge Code |
901698364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$72.92 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Cash Price |
$36.46
|
| Rate for Payer: Central Health Plan Commercial |
$64.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.41
|
| Rate for Payer: EPIC Health Plan Senior |
$32.41
|
| Rate for Payer: Galaxy Health WC |
$68.87
|
| Rate for Payer: Global Benefits Group Commercial |
$48.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.20
|
| Rate for Payer: Multiplan Commercial |
$60.77
|
| Rate for Payer: Networks By Design Commercial |
$52.66
|
| Rate for Payer: Prime Health Services Commercial |
$68.87
|
|
|
HC TUBE ENDOTRACH FSTNR 5.0-8.0MM
|
Facility
|
OP
|
$81.02
|
|
| Hospital Charge Code |
901698364
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$72.92 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.13
|
| Rate for Payer: Blue Shield of California Commercial |
$51.37
|
| Rate for Payer: Blue Shield of California EPN |
$32.33
|
| Rate for Payer: Cash Price |
$36.46
|
| Rate for Payer: Central Health Plan Commercial |
$64.82
|
| Rate for Payer: Cigna of CA HMO |
$51.85
|
| Rate for Payer: Cigna of CA PPO |
$59.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.41
|
| Rate for Payer: EPIC Health Plan Senior |
$32.41
|
| Rate for Payer: Galaxy Health WC |
$68.87
|
| Rate for Payer: Global Benefits Group Commercial |
$48.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$56.71
|
| Rate for Payer: Multiplan Commercial |
$60.77
|
| Rate for Payer: Networks By Design Commercial |
$52.66
|
| Rate for Payer: Prime Health Services Commercial |
$68.87
|
| Rate for Payer: Riverside University Health System MISP |
$32.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.51
|
| Rate for Payer: United Healthcare All Other HMO |
$40.51
|
| Rate for Payer: United Healthcare HMO Rider |
$40.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$40.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.87
|
| Rate for Payer: Vantage Medical Group Senior |
$68.87
|
|
|
HC TUBE ENDOTRACH FSTNR 5-10MM
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901698937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC TUBE ENDOTRACH FSTNR 5-10MM
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901698937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC TUBE ENDOTRACH STYLET SIZE 7.0
|
Facility
|
IP
|
$30.50
|
|
| Hospital Charge Code |
901698943
|
|
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 STYLET SIZE 7.0
|
Facility
|
OP
|
$30.50
|
|
| Hospital Charge Code |
901698943
|
|
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 W/CUFF 6.5MM
|
Facility
|
IP
|
$266.98
|
|
| Hospital Charge Code |
901698707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.40 |
| Max. Negotiated Rate |
$240.28 |
| Rate for Payer: Adventist Health Commercial |
$53.40
|
| Rate for Payer: Cash Price |
$120.14
|
| Rate for Payer: Central Health Plan Commercial |
$213.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$186.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.79
|
| Rate for Payer: EPIC Health Plan Senior |
$106.79
|
| Rate for Payer: Galaxy Health WC |
$226.93
|
| Rate for Payer: Global Benefits Group Commercial |
$160.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$169.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$157.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$200.24
|
| Rate for Payer: Networks By Design Commercial |
$173.54
|
| Rate for Payer: Prime Health Services Commercial |
$226.93
|
|
|
HC TUBE ENDOTRACH W/CUFF 6.5MM
|
Facility
|
OP
|
$266.98
|
|
| Hospital Charge Code |
901698707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.40 |
| Max. Negotiated Rate |
$240.28 |
| Rate for Payer: Adventist Health Commercial |
$53.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$226.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$146.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.30
|
| Rate for Payer: Blue Shield of California Commercial |
$169.27
|
| Rate for Payer: Blue Shield of California EPN |
$106.53
|
| Rate for Payer: Cash Price |
$120.14
|
| Rate for Payer: Central Health Plan Commercial |
$213.58
|
| Rate for Payer: Cigna of CA HMO |
$170.87
|
| Rate for Payer: Cigna of CA PPO |
$197.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$226.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$226.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$186.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.79
|
| Rate for Payer: EPIC Health Plan Senior |
$106.79
|
| Rate for Payer: Galaxy Health WC |
$226.93
|
| Rate for Payer: Global Benefits Group Commercial |
$160.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$240.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$169.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$157.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$186.89
|
| Rate for Payer: Multiplan Commercial |
$200.24
|
| Rate for Payer: Networks By Design Commercial |
$173.54
|
| Rate for Payer: Prime Health Services Commercial |
$226.93
|
| Rate for Payer: Riverside University Health System MISP |
$106.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$160.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$160.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$133.49
|
| Rate for Payer: United Healthcare All Other HMO |
$133.49
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$133.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$226.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$226.93
|
| Rate for Payer: Vantage Medical Group Senior |
$226.93
|
|
