|
HC TUBE TRACH SHILEY 8.5 UNCUFF
|
Facility
|
IP
|
$408.32
|
|
| Hospital Charge Code |
901698521
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.66 |
| Max. Negotiated Rate |
$367.49 |
| Rate for Payer: Adventist Health Commercial |
$81.66
|
| Rate for Payer: Cash Price |
$183.74
|
| Rate for Payer: Central Health Plan Commercial |
$326.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$285.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.33
|
| Rate for Payer: EPIC Health Plan Senior |
$163.33
|
| Rate for Payer: Galaxy Health WC |
$347.07
|
| Rate for Payer: Global Benefits Group Commercial |
$244.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$259.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$240.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.66
|
| Rate for Payer: Multiplan Commercial |
$306.24
|
| Rate for Payer: Networks By Design Commercial |
$265.41
|
| Rate for Payer: Prime Health Services Commercial |
$347.07
|
|
|
HC TUBE TRACH SHILEY CUFFED 6.5MM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698945
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED 6.5MM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698945
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED 7.5MM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED 7.5MM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED 8.5MM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED 8.5MM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ10
|
Facility
|
IP
|
$265.23
|
|
| Hospital Charge Code |
901601129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ10
|
Facility
|
OP
|
$265.23
|
|
| Hospital Charge Code |
901601129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.28
|
| Rate for Payer: Blue Shield of California Commercial |
$168.16
|
| Rate for Payer: Blue Shield of California EPN |
$105.83
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Cigna of CA HMO |
$169.75
|
| Rate for Payer: Cigna of CA PPO |
$196.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.66
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
| Rate for Payer: Riverside University Health System MISP |
$106.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.62
|
| Rate for Payer: United Healthcare All Other HMO |
$132.62
|
| Rate for Payer: United Healthcare HMO Rider |
$132.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.45
|
| Rate for Payer: Vantage Medical Group Senior |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ4
|
Facility
|
IP
|
$265.23
|
|
| Hospital Charge Code |
901601126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ4
|
Facility
|
OP
|
$265.23
|
|
| Hospital Charge Code |
901601126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.28
|
| Rate for Payer: Blue Shield of California Commercial |
$168.16
|
| Rate for Payer: Blue Shield of California EPN |
$105.83
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Cigna of CA HMO |
$169.75
|
| Rate for Payer: Cigna of CA PPO |
$196.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.66
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
| Rate for Payer: Riverside University Health System MISP |
$106.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.62
|
| Rate for Payer: United Healthcare All Other HMO |
$132.62
|
| Rate for Payer: United Healthcare HMO Rider |
$132.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.45
|
| Rate for Payer: Vantage Medical Group Senior |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ 6
|
Facility
|
IP
|
$265.23
|
|
| Hospital Charge Code |
901601127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ 6
|
Facility
|
OP
|
$265.23
|
|
| Hospital Charge Code |
901601127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.28
|
| Rate for Payer: Blue Shield of California Commercial |
$168.16
|
| Rate for Payer: Blue Shield of California EPN |
$105.83
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Cigna of CA HMO |
$169.75
|
| Rate for Payer: Cigna of CA PPO |
$196.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.66
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
| Rate for Payer: Riverside University Health System MISP |
$106.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.62
|
| Rate for Payer: United Healthcare All Other HMO |
$132.62
|
| Rate for Payer: United Healthcare HMO Rider |
$132.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.45
|
| Rate for Payer: Vantage Medical Group Senior |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ 8
|
Facility
|
IP
|
$265.23
|
|
| Hospital Charge Code |
901601128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
|
|
HC TUBE TRACH SHILEY CUFFED SZ 8
|
Facility
|
OP
|
$265.23
|
|
| Hospital Charge Code |
901601128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$238.71 |
| Rate for Payer: Adventist Health Commercial |
$53.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.28
|
| Rate for Payer: Blue Shield of California Commercial |
$168.16
|
| Rate for Payer: Blue Shield of California EPN |
$105.83
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$212.18
|
| Rate for Payer: Cigna of CA HMO |
$169.75
|
| Rate for Payer: Cigna of CA PPO |
$196.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.09
|
| Rate for Payer: EPIC Health Plan Senior |
$106.09
|
| Rate for Payer: Galaxy Health WC |
$225.45
|
| Rate for Payer: Global Benefits Group Commercial |
$159.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.66
|
| Rate for Payer: Multiplan Commercial |
$198.92
|
| Rate for Payer: Networks By Design Commercial |
$172.40
|
| Rate for Payer: Prime Health Services Commercial |
$225.45
|
| Rate for Payer: Riverside University Health System MISP |
$106.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.62
|
| Rate for Payer: United Healthcare All Other HMO |
$132.62
|
| Rate for Payer: United Healthcare HMO Rider |
$132.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.45
|
| Rate for Payer: Vantage Medical Group Senior |
$225.45
|
|
|
HC TUBE TRACH SHILEY NEO 3.5MM
|
Facility
|
OP
|
$212.73
|
|
| Hospital Charge Code |
901601205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$103.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.75
|
| Rate for Payer: Blue Shield of California Commercial |
$134.87
|
| Rate for Payer: Blue Shield of California EPN |
$84.88
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$136.15
|
| Rate for Payer: Cigna of CA PPO |
$157.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.36
|
| Rate for Payer: United Healthcare All Other HMO |
$106.36
|
| Rate for Payer: United Healthcare HMO Rider |
$106.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC TUBE TRACH SHILEY NEO 3.5MM
|
Facility
|
IP
|
$212.73
|
|
| Hospital Charge Code |
901601205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
|
|
HC TUBE TRACH SHILEY NEO 3MM
|
Facility
|
OP
|
$212.73
|
|
| Hospital Charge Code |
901601207
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$103.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.75
|
| Rate for Payer: Blue Shield of California Commercial |
$134.87
|
| Rate for Payer: Blue Shield of California EPN |
$84.88
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$136.15
|
| Rate for Payer: Cigna of CA PPO |
$157.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.36
|
| Rate for Payer: United Healthcare All Other HMO |
$106.36
|
| Rate for Payer: United Healthcare HMO Rider |
$106.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC TUBE TRACH SHILEY NEO 3MM
|
Facility
|
IP
|
$212.73
|
|
| Hospital Charge Code |
901601207
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
|
|
HC TUBE TRACH SHILEY NEO 4.0MM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
901698444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH SHILEY NEO 4.0MM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
901698444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH SHILEY NEO 4MM
|
Facility
|
IP
|
$212.73
|
|
| Hospital Charge Code |
901601217
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
|
|
HC TUBE TRACH SHILEY NEO 4MM
|
Facility
|
OP
|
$212.73
|
|
| Hospital Charge Code |
901601217
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$103.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.75
|
| Rate for Payer: Blue Shield of California Commercial |
$134.87
|
| Rate for Payer: Blue Shield of California EPN |
$84.88
|
| Rate for Payer: Cash Price |
$95.73
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$136.15
|
| Rate for Payer: Cigna of CA PPO |
$157.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.36
|
| Rate for Payer: United Healthcare All Other HMO |
$106.36
|
| Rate for Payer: United Healthcare HMO Rider |
$106.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC TUBE TRACH SHILEY PEDS 3.5
|
Facility
|
OP
|
$224.98
|
|
| Hospital Charge Code |
901601131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$202.48 |
| Rate for Payer: Adventist Health Commercial |
$45.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$168.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.87
|
| Rate for Payer: Blue Shield of California Commercial |
$142.64
|
| Rate for Payer: Blue Shield of California EPN |
$89.77
|
| Rate for Payer: Cash Price |
$101.24
|
| Rate for Payer: Central Health Plan Commercial |
$179.98
|
| Rate for Payer: Cigna of CA HMO |
$143.99
|
| Rate for Payer: Cigna of CA PPO |
$166.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$191.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$191.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$157.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.99
|
| Rate for Payer: EPIC Health Plan Senior |
$89.99
|
| Rate for Payer: Galaxy Health WC |
$191.23
|
| Rate for Payer: Global Benefits Group Commercial |
$134.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$157.49
|
| Rate for Payer: Multiplan Commercial |
$168.74
|
| Rate for Payer: Networks By Design Commercial |
$146.24
|
| Rate for Payer: Prime Health Services Commercial |
$191.23
|
| Rate for Payer: Riverside University Health System MISP |
$89.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$134.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$134.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$112.49
|
| Rate for Payer: United Healthcare All Other HMO |
$112.49
|
| Rate for Payer: United Healthcare HMO Rider |
$112.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$112.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.23
|
| Rate for Payer: Vantage Medical Group Senior |
$191.23
|
|
|
HC TUBE TRACH SHILEY PEDS 3.5
|
Facility
|
IP
|
$224.98
|
|
| Hospital Charge Code |
901601131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$202.48 |
| Rate for Payer: Adventist Health Commercial |
$45.00
|
| Rate for Payer: Cash Price |
$101.24
|
| Rate for Payer: Central Health Plan Commercial |
$179.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$157.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.99
|
| Rate for Payer: EPIC Health Plan Senior |
$89.99
|
| Rate for Payer: Galaxy Health WC |
$191.23
|
| Rate for Payer: Global Benefits Group Commercial |
$134.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.00
|
| Rate for Payer: Multiplan Commercial |
$168.74
|
| Rate for Payer: Networks By Design Commercial |
$146.24
|
| Rate for Payer: Prime Health Services Commercial |
$191.23
|
|
