HC TUBE CHECK (ABSCESS/CYST)
|
Facility
|
OP
|
$381.00
|
|
Service Code
|
CPT 49424
|
Hospital Charge Code |
909000212
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$67.91 |
Max. Negotiated Rate |
$7,609.02 |
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$323.85
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$209.55
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.55
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
Rate for Payer: Blue Distinction Transplant |
$228.60
|
Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
Rate for Payer: Cash Price |
$171.45
|
Rate for Payer: Cash Price |
$171.45
|
Rate for Payer: Cash Price |
$171.45
|
Rate for Payer: Central Health Plan Commercial |
$304.80
|
Rate for Payer: Cigna of CA PPO |
$281.94
|
Rate for Payer: Dignity Health Commercial/Exchange |
$323.85
|
Rate for Payer: Dignity Health Media |
$323.85
|
Rate for Payer: Dignity Health Medi-Cal |
$323.85
|
Rate for Payer: EPIC Health Plan Commercial |
$152.40
|
Rate for Payer: EPIC Health Plan Transplant |
$152.40
|
Rate for Payer: Galaxy Health WC |
$323.85
|
Rate for Payer: Global Benefits Group Commercial |
$228.60
|
Rate for Payer: Health Management Network EPO/PPO |
$342.90
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$285.75
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$133.35
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$254.13
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.91
|
Rate for Payer: LLUH Dept of Risk Management WC |
$76.20
|
Rate for Payer: Multiplan Commercial |
$285.75
|
Rate for Payer: Networks By Design Commercial |
$247.65
|
Rate for Payer: Prime Health Services Commercial |
$323.85
|
Rate for Payer: Riverside University Health System MISP |
$152.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$228.60
|
Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$323.85
|
Rate for Payer: Vantage Medical Group Senior |
$323.85
|
|
HC TUBE ENDOTRACH 2.0MM UNCUFF
|
Facility
|
IP
|
$13.86
|
|
Hospital Charge Code |
901698583
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.77 |
Max. Negotiated Rate |
$12.47 |
Rate for Payer: Cash Price |
$6.24
|
Rate for Payer: Central Health Plan Commercial |
$11.09
|
Rate for Payer: EPIC Health Plan Commercial |
$5.54
|
Rate for Payer: Galaxy Health WC |
$11.78
|
Rate for Payer: Global Benefits Group Commercial |
$8.32
|
Rate for Payer: Health Management Network EPO/PPO |
$12.47
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.24
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.28
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.77
|
Rate for Payer: Multiplan Commercial |
$10.40
|
Rate for Payer: Networks By Design Commercial |
$9.01
|
Rate for Payer: Prime Health Services Commercial |
$11.78
|
|
HC TUBE ENDOTRACH 2.0MM UNCUFF
|
Facility
|
OP
|
$13.86
|
|
Hospital Charge Code |
901698583
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.77 |
Max. Negotiated Rate |
$12.47 |
Rate for Payer: Aetna of CA HMO/PPO |
$8.42
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.78
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.62
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.62
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.71
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.19
|
Rate for Payer: Blue Distinction Transplant |
$8.32
|
Rate for Payer: Blue Shield of California Commercial |
$8.72
|
Rate for Payer: Blue Shield of California EPN |
$6.78
|
Rate for Payer: Cash Price |
$6.24
|
Rate for Payer: Central Health Plan Commercial |
$11.09
|
Rate for Payer: Cigna of CA HMO |
$8.87
|
Rate for Payer: Cigna of CA PPO |
$10.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$11.78
|
Rate for Payer: Dignity Health Media |
$11.78
|
Rate for Payer: Dignity Health Medi-Cal |
$11.78
|
Rate for Payer: EPIC Health Plan Commercial |
$5.54
|
Rate for Payer: EPIC Health Plan Transplant |
$5.54
|
Rate for Payer: Galaxy Health WC |
$11.78
|
Rate for Payer: Global Benefits Group Commercial |
$8.32
|
Rate for Payer: Health Management Network EPO/PPO |
$12.47
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.40
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.85
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.24
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.28
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.77
|
Rate for Payer: Multiplan Commercial |
$10.40
|
Rate for Payer: Networks By Design Commercial |
$9.01
|
Rate for Payer: Prime Health Services Commercial |
$11.78
|
Rate for Payer: Riverside University Health System MISP |
$5.54
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.32
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.32
|
Rate for Payer: United Healthcare All Other Commercial |
$6.93
|
Rate for Payer: United Healthcare All Other HMO |
$6.93
|
Rate for Payer: United Healthcare HMO Rider |
$6.93
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$6.93
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$11.78
|
Rate for Payer: Vantage Medical Group Senior |
$11.78
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$15.42
|
|
Hospital Charge Code |
901698584
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3.08 |
Max. Negotiated Rate |
$13.88 |
Rate for Payer: Aetna of CA HMO/PPO |
$9.36
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.11
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.48
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.47
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.11
|
Rate for Payer: Blue Distinction Transplant |
$9.25
|
Rate for Payer: Blue Shield of California Commercial |
$9.70
|
Rate for Payer: Blue Shield of California EPN |
$7.54
|
Rate for Payer: Cash Price |
$6.94
|
Rate for Payer: Central Health Plan Commercial |
$12.34
|
Rate for Payer: Cigna of CA HMO |
$9.87
|
Rate for Payer: Cigna of CA PPO |
$11.41
|
Rate for Payer: Dignity Health Commercial/Exchange |
$13.11
|
Rate for Payer: Dignity Health Media |
$13.11
|
Rate for Payer: Dignity Health Medi-Cal |
$13.11
|
Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
Rate for Payer: EPIC Health Plan Transplant |
$6.17
|
Rate for Payer: Galaxy Health WC |
$13.11
|
Rate for Payer: Global Benefits Group Commercial |
$9.25
|
Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.29
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.88
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
Rate for Payer: Multiplan Commercial |
$11.56
|
Rate for Payer: Networks By Design Commercial |
$10.02
|
Rate for Payer: Prime Health Services Commercial |
$13.11
|
Rate for Payer: Riverside University Health System MISP |
$6.17
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
Rate for Payer: United Healthcare All Other Commercial |
$7.71
|
Rate for Payer: United Healthcare All Other HMO |
$7.71
|
Rate for Payer: United Healthcare HMO Rider |
$7.71
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.71
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$13.11
|
Rate for Payer: Vantage Medical Group Senior |
$13.11
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
IP
|
$15.42
|
|
Hospital Charge Code |
901698584
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3.08 |
Max. Negotiated Rate |
$13.88 |
Rate for Payer: Cash Price |
$6.94
|
Rate for Payer: Central Health Plan Commercial |
$12.34
|
Rate for Payer: EPIC Health Plan Commercial |
$6.17
|
Rate for Payer: Galaxy Health WC |
$13.11
|
Rate for Payer: Global Benefits Group Commercial |
$9.25
|
Rate for Payer: Health Management Network EPO/PPO |
$13.88
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.29
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.88
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
Rate for Payer: Multiplan Commercial |
$11.56
|
Rate for Payer: Networks By Design Commercial |
$10.02
|
Rate for Payer: Prime Health Services Commercial |
$13.11
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
Hospital Charge Code |
901607701
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Aetna of CA HMO/PPO |
$9.01
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.61
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.16
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.16
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.77
|
Rate for Payer: Blue Distinction Transplant |
$8.90
|
Rate for Payer: Blue Shield of California Commercial |
$9.33
|
Rate for Payer: Blue Shield of California EPN |
$7.26
|
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: Cigna of CA HMO |
$9.50
|
Rate for Payer: Cigna of CA PPO |
$10.98
|
Rate for Payer: Dignity Health Commercial/Exchange |
$12.61
|
Rate for Payer: Dignity Health Media |
$12.61
|
Rate for Payer: Dignity Health Medi-Cal |
$12.61
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: EPIC Health Plan Transplant |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
Rate for Payer: Riverside University Health System MISP |
$5.94
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.90
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.90
|
Rate for Payer: United Healthcare All Other Commercial |
$7.42
|
Rate for Payer: United Healthcare All Other HMO |
$7.42
|
Rate for Payer: United Healthcare HMO Rider |
$7.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.42
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$12.61
|
Rate for Payer: Vantage Medical Group Senior |
$12.61
|
|
HC TUBE ENDOTRACH 2.5MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
Hospital Charge Code |
901607701
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
Hospital Charge Code |
901607702
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Aetna of CA HMO/PPO |
$9.01
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.61
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.16
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.16
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.77
|
Rate for Payer: Blue Distinction Transplant |
$8.90
|
Rate for Payer: Blue Shield of California Commercial |
$9.33
|
Rate for Payer: Blue Shield of California EPN |
$7.26
|
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: Cigna of CA HMO |
$9.50
|
Rate for Payer: Cigna of CA PPO |
$10.98
|
Rate for Payer: Dignity Health Commercial/Exchange |
$12.61
|
Rate for Payer: Dignity Health Media |
$12.61
|
Rate for Payer: Dignity Health Medi-Cal |
$12.61
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: EPIC Health Plan Transplant |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
Rate for Payer: Riverside University Health System MISP |
$5.94
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.90
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.90
|
Rate for Payer: United Healthcare All Other Commercial |
$7.42
|
Rate for Payer: United Healthcare All Other HMO |
$7.42
|
Rate for Payer: United Healthcare HMO Rider |
$7.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.42
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$12.61
|
Rate for Payer: Vantage Medical Group Senior |
$12.61
|
|
HC TUBE ENDOTRACH 3.0MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
Hospital Charge Code |
901607702
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
|
HC TUBE ENDOTRACH 3.0MM W/CUFF
|
Facility
|
OP
|
$27.14
|
|
Hospital Charge Code |
901698731
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.43 |
Max. Negotiated Rate |
$24.43 |
Rate for Payer: Aetna of CA HMO/PPO |
$16.48
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.07
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.93
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.93
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.14
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.03
|
Rate for Payer: Blue Distinction Transplant |
$16.28
|
Rate for Payer: Blue Shield of California Commercial |
$17.07
|
Rate for Payer: Blue Shield of California EPN |
$13.27
|
Rate for Payer: Cash Price |
$12.21
|
Rate for Payer: Central Health Plan Commercial |
$21.71
|
Rate for Payer: Cigna of CA HMO |
$17.37
|
Rate for Payer: Cigna of CA PPO |
$20.08
|
Rate for Payer: Dignity Health Commercial/Exchange |
$23.07
|
Rate for Payer: Dignity Health Media |
$23.07
|
Rate for Payer: Dignity Health Medi-Cal |
$23.07
|
Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
Rate for Payer: EPIC Health Plan Transplant |
$10.86
|
Rate for Payer: Galaxy Health WC |
$23.07
|
Rate for Payer: Global Benefits Group Commercial |
$16.28
|
Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.36
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.50
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
Rate for Payer: Multiplan Commercial |
$20.36
|
Rate for Payer: Networks By Design Commercial |
$17.64
|
Rate for Payer: Prime Health Services Commercial |
$23.07
|
Rate for Payer: Riverside University Health System MISP |
$10.86
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.28
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.28
|
Rate for Payer: United Healthcare All Other Commercial |
$13.57
|
Rate for Payer: United Healthcare All Other HMO |
$13.57
|
Rate for Payer: United Healthcare HMO Rider |
$13.57
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$13.57
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$23.07
|
Rate for Payer: Vantage Medical Group Senior |
$23.07
|
|
HC TUBE ENDOTRACH 3.0MM W/CUFF
|
Facility
|
IP
|
$27.14
|
|
Hospital Charge Code |
901698731
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.43 |
Max. Negotiated Rate |
$24.43 |
Rate for Payer: Cash Price |
$12.21
|
Rate for Payer: Central Health Plan Commercial |
$21.71
|
Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
Rate for Payer: Galaxy Health WC |
$23.07
|
Rate for Payer: Global Benefits Group Commercial |
$16.28
|
Rate for Payer: Health Management Network EPO/PPO |
$24.43
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
Rate for Payer: LLUH Dept of Risk Management WC |
$5.43
|
Rate for Payer: Multiplan Commercial |
$20.36
|
Rate for Payer: Networks By Design Commercial |
$17.64
|
Rate for Payer: Prime Health Services Commercial |
$23.07
|
|
HC TUBE ENDOTRACH 3.5MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
Hospital Charge Code |
901607703
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
|
HC TUBE ENDOTRACH 3.5MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
Hospital Charge Code |
901607703
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Aetna of CA HMO/PPO |
$9.01
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.61
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.16
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.16
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.77
|
Rate for Payer: Blue Distinction Transplant |
$8.90
|
Rate for Payer: Blue Shield of California Commercial |
$9.33
|
Rate for Payer: Blue Shield of California EPN |
$7.26
|
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: Cigna of CA HMO |
$9.50
|
Rate for Payer: Cigna of CA PPO |
$10.98
|
Rate for Payer: Dignity Health Commercial/Exchange |
$12.61
|
Rate for Payer: Dignity Health Media |
$12.61
|
Rate for Payer: Dignity Health Medi-Cal |
$12.61
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: EPIC Health Plan Transplant |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
Rate for Payer: Riverside University Health System MISP |
$5.94
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.90
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.90
|
Rate for Payer: United Healthcare All Other Commercial |
$7.42
|
Rate for Payer: United Healthcare All Other HMO |
$7.42
|
Rate for Payer: United Healthcare HMO Rider |
$7.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.42
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$12.61
|
Rate for Payer: Vantage Medical Group Senior |
$12.61
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
IP
|
$22.63
|
|
Hospital Charge Code |
901604957
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
IP
|
$13.20
|
|
Hospital Charge Code |
901698732
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.64 |
Max. Negotiated Rate |
$11.88 |
Rate for Payer: Cash Price |
$5.94
|
Rate for Payer: Central Health Plan Commercial |
$10.56
|
Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
Rate for Payer: Galaxy Health WC |
$11.22
|
Rate for Payer: Global Benefits Group Commercial |
$7.92
|
Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
Rate for Payer: Multiplan Commercial |
$9.90
|
Rate for Payer: Networks By Design Commercial |
$8.58
|
Rate for Payer: Prime Health Services Commercial |
$11.22
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
OP
|
$13.20
|
|
Hospital Charge Code |
901698732
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.64 |
Max. Negotiated Rate |
$11.88 |
Rate for Payer: Aetna of CA HMO/PPO |
$8.02
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.39
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.80
|
Rate for Payer: Blue Distinction Transplant |
$7.92
|
Rate for Payer: Blue Shield of California Commercial |
$8.30
|
Rate for Payer: Blue Shield of California EPN |
$6.45
|
Rate for Payer: Cash Price |
$5.94
|
Rate for Payer: Central Health Plan Commercial |
$10.56
|
Rate for Payer: Cigna of CA HMO |
$8.45
|
Rate for Payer: Cigna of CA PPO |
$9.77
|
Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
Rate for Payer: Dignity Health Media |
$11.22
|
Rate for Payer: Dignity Health Medi-Cal |
$11.22
|
Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
Rate for Payer: EPIC Health Plan Transplant |
$5.28
|
Rate for Payer: Galaxy Health WC |
$11.22
|
Rate for Payer: Global Benefits Group Commercial |
$7.92
|
Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.90
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.62
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
Rate for Payer: Multiplan Commercial |
$9.90
|
Rate for Payer: Networks By Design Commercial |
$8.58
|
Rate for Payer: Prime Health Services Commercial |
$11.22
|
Rate for Payer: Riverside University Health System MISP |
$5.28
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.92
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.92
|
Rate for Payer: United Healthcare All Other Commercial |
$6.60
|
Rate for Payer: United Healthcare All Other HMO |
$6.60
|
Rate for Payer: United Healthcare HMO Rider |
$6.60
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$6.60
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$11.22
|
Rate for Payer: Vantage Medical Group Senior |
$11.22
|
|
HC TUBE ENDOTRACH 3.5MM W/CUFF
|
Facility
|
OP
|
$22.63
|
|
Hospital Charge Code |
901604957
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Aetna of CA HMO/PPO |
$13.74
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.24
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.45
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.45
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.96
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.37
|
Rate for Payer: Blue Distinction Transplant |
$13.58
|
Rate for Payer: Blue Shield of California Commercial |
$14.23
|
Rate for Payer: Blue Shield of California EPN |
$11.07
|
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: Cigna of CA HMO |
$14.48
|
Rate for Payer: Cigna of CA PPO |
$16.75
|
Rate for Payer: Dignity Health Commercial/Exchange |
$19.24
|
Rate for Payer: Dignity Health Media |
$19.24
|
Rate for Payer: Dignity Health Medi-Cal |
$19.24
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: EPIC Health Plan Transplant |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.97
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.92
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
Rate for Payer: Riverside University Health System MISP |
$9.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.58
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.58
|
Rate for Payer: United Healthcare All Other Commercial |
$11.32
|
Rate for Payer: United Healthcare All Other HMO |
$11.32
|
Rate for Payer: United Healthcare HMO Rider |
$11.32
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$11.32
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.24
|
Rate for Payer: Vantage Medical Group Senior |
$19.24
|
|
HC TUBE ENDOTRACH 3.OMM W/CUFF
|
Facility
|
IP
|
$22.63
|
|
Hospital Charge Code |
901604914
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
|
HC TUBE ENDOTRACH 3.OMM W/CUFF
|
Facility
|
OP
|
$22.63
|
|
Hospital Charge Code |
901604914
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Aetna of CA HMO/PPO |
$13.74
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.24
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.45
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.45
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.96
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.37
|
Rate for Payer: Blue Distinction Transplant |
$13.58
|
Rate for Payer: Blue Shield of California Commercial |
$14.23
|
Rate for Payer: Blue Shield of California EPN |
$11.07
|
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: Cigna of CA HMO |
$14.48
|
Rate for Payer: Cigna of CA PPO |
$16.75
|
Rate for Payer: Dignity Health Commercial/Exchange |
$19.24
|
Rate for Payer: Dignity Health Media |
$19.24
|
Rate for Payer: Dignity Health Medi-Cal |
$19.24
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: EPIC Health Plan Transplant |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.97
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.92
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
Rate for Payer: Riverside University Health System MISP |
$9.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.58
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.58
|
Rate for Payer: United Healthcare All Other Commercial |
$11.32
|
Rate for Payer: United Healthcare All Other HMO |
$11.32
|
Rate for Payer: United Healthcare HMO Rider |
$11.32
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$11.32
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.24
|
Rate for Payer: Vantage Medical Group Senior |
$19.24
|
|
HC TUBE ENDOTRACH 4.0MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
Hospital Charge Code |
901607704
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Aetna of CA HMO/PPO |
$9.01
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.61
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.16
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.16
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.77
|
Rate for Payer: Blue Distinction Transplant |
$8.90
|
Rate for Payer: Blue Shield of California Commercial |
$9.33
|
Rate for Payer: Blue Shield of California EPN |
$7.26
|
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: Cigna of CA HMO |
$9.50
|
Rate for Payer: Cigna of CA PPO |
$10.98
|
Rate for Payer: Dignity Health Commercial/Exchange |
$12.61
|
Rate for Payer: Dignity Health Media |
$12.61
|
Rate for Payer: Dignity Health Medi-Cal |
$12.61
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: EPIC Health Plan Transplant |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
Rate for Payer: Riverside University Health System MISP |
$5.94
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.90
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.90
|
Rate for Payer: United Healthcare All Other Commercial |
$7.42
|
Rate for Payer: United Healthcare All Other HMO |
$7.42
|
Rate for Payer: United Healthcare HMO Rider |
$7.42
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.42
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$12.61
|
Rate for Payer: Vantage Medical Group Senior |
$12.61
|
|
HC TUBE ENDOTRACH 4.0MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
Hospital Charge Code |
901607704
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.97 |
Max. Negotiated Rate |
$13.36 |
Rate for Payer: Cash Price |
$6.68
|
Rate for Payer: Central Health Plan Commercial |
$11.87
|
Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
Rate for Payer: Galaxy Health WC |
$12.61
|
Rate for Payer: Global Benefits Group Commercial |
$8.90
|
Rate for Payer: Health Management Network EPO/PPO |
$13.36
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.65
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
Rate for Payer: Multiplan Commercial |
$11.13
|
Rate for Payer: Networks By Design Commercial |
$9.65
|
Rate for Payer: Prime Health Services Commercial |
$12.61
|
|
HC TUBE ENDOTRACH 4.0MM W/CUFF
|
Facility
|
IP
|
$22.63
|
|
Hospital Charge Code |
901604915
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
|
HC TUBE ENDOTRACH 4.0MM W/CUFF
|
Facility
|
OP
|
$13.20
|
|
Hospital Charge Code |
901698733
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.64 |
Max. Negotiated Rate |
$11.88 |
Rate for Payer: Aetna of CA HMO/PPO |
$8.02
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.39
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.80
|
Rate for Payer: Blue Distinction Transplant |
$7.92
|
Rate for Payer: Blue Shield of California Commercial |
$8.30
|
Rate for Payer: Blue Shield of California EPN |
$6.45
|
Rate for Payer: Cash Price |
$5.94
|
Rate for Payer: Central Health Plan Commercial |
$10.56
|
Rate for Payer: Cigna of CA HMO |
$8.45
|
Rate for Payer: Cigna of CA PPO |
$9.77
|
Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
Rate for Payer: Dignity Health Media |
$11.22
|
Rate for Payer: Dignity Health Medi-Cal |
$11.22
|
Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
Rate for Payer: EPIC Health Plan Transplant |
$5.28
|
Rate for Payer: Galaxy Health WC |
$11.22
|
Rate for Payer: Global Benefits Group Commercial |
$7.92
|
Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.90
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.62
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
Rate for Payer: Multiplan Commercial |
$9.90
|
Rate for Payer: Networks By Design Commercial |
$8.58
|
Rate for Payer: Prime Health Services Commercial |
$11.22
|
Rate for Payer: Riverside University Health System MISP |
$5.28
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.92
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.92
|
Rate for Payer: United Healthcare All Other Commercial |
$6.60
|
Rate for Payer: United Healthcare All Other HMO |
$6.60
|
Rate for Payer: United Healthcare HMO Rider |
$6.60
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$6.60
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$11.22
|
Rate for Payer: Vantage Medical Group Senior |
$11.22
|
|
HC TUBE ENDOTRACH 4.0MM W/CUFF
|
Facility
|
IP
|
$13.20
|
|
Hospital Charge Code |
901698733
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.64 |
Max. Negotiated Rate |
$11.88 |
Rate for Payer: Cash Price |
$5.94
|
Rate for Payer: Central Health Plan Commercial |
$10.56
|
Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
Rate for Payer: Galaxy Health WC |
$11.22
|
Rate for Payer: Global Benefits Group Commercial |
$7.92
|
Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
Rate for Payer: Multiplan Commercial |
$9.90
|
Rate for Payer: Networks By Design Commercial |
$8.58
|
Rate for Payer: Prime Health Services Commercial |
$11.22
|
|
HC TUBE ENDOTRACH 4.0MM W/CUFF
|
Facility
|
OP
|
$22.63
|
|
Hospital Charge Code |
901604915
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.53 |
Max. Negotiated Rate |
$20.37 |
Rate for Payer: Aetna of CA HMO/PPO |
$13.74
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.24
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.45
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.45
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.96
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.37
|
Rate for Payer: Blue Distinction Transplant |
$13.58
|
Rate for Payer: Blue Shield of California Commercial |
$14.23
|
Rate for Payer: Blue Shield of California EPN |
$11.07
|
Rate for Payer: Cash Price |
$10.18
|
Rate for Payer: Central Health Plan Commercial |
$18.10
|
Rate for Payer: Cigna of CA HMO |
$14.48
|
Rate for Payer: Cigna of CA PPO |
$16.75
|
Rate for Payer: Dignity Health Commercial/Exchange |
$19.24
|
Rate for Payer: Dignity Health Media |
$19.24
|
Rate for Payer: Dignity Health Medi-Cal |
$19.24
|
Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
Rate for Payer: EPIC Health Plan Transplant |
$9.05
|
Rate for Payer: Galaxy Health WC |
$19.24
|
Rate for Payer: Global Benefits Group Commercial |
$13.58
|
Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.97
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.92
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
Rate for Payer: Multiplan Commercial |
$16.97
|
Rate for Payer: Networks By Design Commercial |
$14.71
|
Rate for Payer: Prime Health Services Commercial |
$19.24
|
Rate for Payer: Riverside University Health System MISP |
$9.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.58
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.58
|
Rate for Payer: United Healthcare All Other Commercial |
$11.32
|
Rate for Payer: United Healthcare All Other HMO |
$11.32
|
Rate for Payer: United Healthcare HMO Rider |
$11.32
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$11.32
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.24
|
Rate for Payer: Vantage Medical Group Senior |
$19.24
|
|