|
HC TRACH SHILEY PEDS 3.5 UNCUFF
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| 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 TRACH SHILEY PEDS 3.5 UNCUFF
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| 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: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TRACH SHILEY PEDS 4.0 CUFFED
|
Facility
OP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$346.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$224.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$224.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.96
|
| Rate for Payer: BCBS Transplant Transplant |
$244.72
|
| Rate for Payer: Blue Shield of California Commercial |
$256.54
|
| Rate for Payer: Blue Shield of California EPN |
$199.44
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: Cigna of CA HMO |
$261.03
|
| Rate for Payer: Cigna of CA PPO |
$301.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$346.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$305.90
|
| Rate for Payer: IEHP medi-cal |
$142.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: Riverside University Health MISP |
$163.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$244.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$203.93
|
| Rate for Payer: United Healthcare All Other HMO |
$203.93
|
| Rate for Payer: United Healthcare HMO Rider |
$203.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$203.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$346.68
|
| Rate for Payer: Vantage Medical Group Senior |
$346.68
|
|
|
HC TRACH SHILEY PEDS 4.0 CUFFED
|
Facility
IP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
|
|
HC TRACH SHILEY PEDS 4.0 UNCUFF
|
Facility
OP
|
$331.66
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698496
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.33 |
| Max. Negotiated Rate |
$298.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$281.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$182.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$182.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$160.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.94
|
| Rate for Payer: BCBS Transplant Transplant |
$199.00
|
| Rate for Payer: Blue Shield of California Commercial |
$208.61
|
| Rate for Payer: Blue Shield of California EPN |
$162.18
|
| Rate for Payer: Cash Price |
$149.25
|
| Rate for Payer: Cash Price |
$149.25
|
| Rate for Payer: Central Health Plan Commercial |
$265.33
|
| Rate for Payer: Cigna of CA HMO |
$212.26
|
| Rate for Payer: Cigna of CA PPO |
$245.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$281.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$132.66
|
| Rate for Payer: Galaxy Health WC |
$281.91
|
| Rate for Payer: Global Benefits Group Commercial |
$199.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$248.74
|
| Rate for Payer: IEHP medi-cal |
$116.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.33
|
| Rate for Payer: Multiplan Commercial |
$248.74
|
| Rate for Payer: Networks By Design Commercial |
$215.58
|
| Rate for Payer: Prime Health Services Commercial |
$281.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$199.00
|
| Rate for Payer: Riverside University Health MISP |
$132.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.83
|
| Rate for Payer: United Healthcare All Other HMO |
$165.83
|
| Rate for Payer: United Healthcare HMO Rider |
$165.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$165.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.91
|
| Rate for Payer: Vantage Medical Group Senior |
$281.91
|
|
|
HC TRACH SHILEY PEDS 4.0 UNCUFF
|
Facility
IP
|
$331.66
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698496
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.33 |
| Max. Negotiated Rate |
$298.49 |
| Rate for Payer: Cash Price |
$149.25
|
| Rate for Payer: Central Health Plan Commercial |
$265.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.66
|
| Rate for Payer: Galaxy Health WC |
$281.91
|
| Rate for Payer: Global Benefits Group Commercial |
$199.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.33
|
| Rate for Payer: Multiplan Commercial |
$248.74
|
| Rate for Payer: Networks By Design Commercial |
$215.58
|
| Rate for Payer: Prime Health Services Commercial |
$281.91
|
|
|
HC TRACH SHILEY PEDS 4.5 CUFFED
|
Facility
OP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$346.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$224.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$224.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.96
|
| Rate for Payer: BCBS Transplant Transplant |
$244.72
|
| Rate for Payer: Blue Shield of California Commercial |
$256.54
|
| Rate for Payer: Blue Shield of California EPN |
$199.44
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: Cigna of CA HMO |
$261.03
|
| Rate for Payer: Cigna of CA PPO |
$301.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$346.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$305.90
|
| Rate for Payer: IEHP medi-cal |
$142.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: Riverside University Health MISP |
$163.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$244.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$203.93
|
| Rate for Payer: United Healthcare All Other HMO |
$203.93
|
| Rate for Payer: United Healthcare HMO Rider |
$203.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$203.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$346.68
|
| Rate for Payer: Vantage Medical Group Senior |
$346.68
|
|
|
HC TRACH SHILEY PEDS 4.5 CUFFED
|
Facility
IP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
|
|
HC TRACH SHILEY PEDS 4.5 UNCUFF
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| 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: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TRACH SHILEY PEDS 4.5 UNCUFF
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| 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 TRACH SHILEY PEDS 5.0 CUFFED
|
Facility
OP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$346.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$224.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$224.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.96
|
| Rate for Payer: BCBS Transplant Transplant |
$244.72
|
| Rate for Payer: Blue Shield of California Commercial |
$256.54
|
| Rate for Payer: Blue Shield of California EPN |
$199.44
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: Cigna of CA HMO |
$261.03
|
| Rate for Payer: Cigna of CA PPO |
$301.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$346.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$305.90
|
| Rate for Payer: IEHP medi-cal |
$142.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: Riverside University Health MISP |
$163.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$244.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$203.93
|
| Rate for Payer: United Healthcare All Other HMO |
$203.93
|
| Rate for Payer: United Healthcare HMO Rider |
$203.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$203.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$346.68
|
| Rate for Payer: Vantage Medical Group Senior |
$346.68
|
|
|
HC TRACH SHILEY PEDS 5.0 CUFFED
|
Facility
IP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
|
|
HC TRACH SHILEY PEDS 5.0 UNCUFF
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| 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: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TRACH SHILEY PEDS 5.0 UNCUFF
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| 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 TRACH SHILEY PEDS 5.5 CUFFED
|
Facility
IP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698504
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
|
|
HC TRACH SHILEY PEDS 5.5 CUFFED
|
Facility
OP
|
$407.86
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
901698504
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.57 |
| Max. Negotiated Rate |
$367.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$346.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$224.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$224.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.96
|
| Rate for Payer: BCBS Transplant Transplant |
$244.72
|
| Rate for Payer: Blue Shield of California Commercial |
$256.54
|
| Rate for Payer: Blue Shield of California EPN |
$199.44
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Cash Price |
$183.54
|
| Rate for Payer: Central Health Plan Commercial |
$326.29
|
| Rate for Payer: Cigna of CA HMO |
$261.03
|
| Rate for Payer: Cigna of CA PPO |
$301.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$346.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.14
|
| Rate for Payer: Galaxy Health WC |
$346.68
|
| Rate for Payer: Global Benefits Group Commercial |
$244.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$367.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$305.90
|
| Rate for Payer: IEHP medi-cal |
$142.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.57
|
| Rate for Payer: Multiplan Commercial |
$305.90
|
| Rate for Payer: Networks By Design Commercial |
$265.11
|
| Rate for Payer: Prime Health Services Commercial |
$346.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: Riverside University Health MISP |
$163.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$244.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$244.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$203.93
|
| Rate for Payer: United Healthcare All Other HMO |
$203.93
|
| Rate for Payer: United Healthcare HMO Rider |
$203.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$203.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$346.68
|
| Rate for Payer: Vantage Medical Group Senior |
$346.68
|
|
|
HC TRACH SHILEY PEDS 5.5 UNCUFF
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| 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 TRACH SHILEY PEDS 5.5 UNCUFF
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
901698499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| 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: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TRACH TUBE CHANGE
|
Facility
IP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$302.20 |
| Max. Negotiated Rate |
$1,359.90 |
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.40
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
|
|
HC TRACH TUBE CHANGE
|
Facility
IP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$302.20 |
| Max. Negotiated Rate |
$1,359.90 |
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.40
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
|
|
HC TRACH TUBE CHANGE
|
Facility
OP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$906.60
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: Cigna of CA PPO |
$1,118.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,133.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$906.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$755.50
|
| Rate for Payer: United Healthcare All Other HMO |
$755.50
|
| Rate for Payer: United Healthcare HMO Rider |
$755.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$755.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC TRACH TUBE CHANGE
|
Facility
OP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$302.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$906.60
|
| Rate for Payer: Blue Shield of California Commercial |
$950.42
|
| Rate for Payer: Blue Shield of California EPN |
$738.88
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: Cigna of CA HMO |
$967.04
|
| Rate for Payer: Cigna of CA PPO |
$1,118.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,133.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$906.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$755.50
|
| Rate for Payer: United Healthcare All Other HMO |
$755.50
|
| Rate for Payer: United Healthcare HMO Rider |
$755.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$755.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC TRACH TUBE CHANGE
|
Facility
OP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$287.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$906.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: Cigna of CA HMO |
$967.04
|
| Rate for Payer: Cigna of CA PPO |
$1,118.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,133.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$906.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC TRACH TUBE CHANGE
|
Facility
IP
|
$1,511.00
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
900800523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.20 |
| Max. Negotiated Rate |
$1,359.90 |
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.40
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,359.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.20
|
| Rate for Payer: Multiplan Commercial |
$1,133.25
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
|
|
HC TRACH TUBE HOLDER 1 SZ
|
Facility
IP
|
$15.33
|
|
|
Service Code
|
CPT A7526
|
| Hospital Charge Code |
901698588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
