|
HC TUBE ENDOTRACH 4.5 CUFFED
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901604956
|
|
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 4.5 CUFFED
|
Facility
|
IP
|
$22.63
|
|
| Hospital Charge Code |
901604956
|
|
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 4.5MM NO CUFF
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
913200744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Cash Price |
$4.13
|
| Rate for Payer: Central Health Plan Commercial |
$7.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.67
|
| Rate for Payer: Galaxy Health WC |
$7.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.84
|
| Rate for Payer: Multiplan Commercial |
$6.88
|
| Rate for Payer: Networks By Design Commercial |
$5.97
|
| Rate for Payer: Prime Health Services Commercial |
$7.80
|
|
|
HC TUBE ENDOTRACH 4.5MM NO CUFF
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
913200744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.42
|
| Rate for Payer: Blue Distinction Transplant |
$5.51
|
| Rate for Payer: Blue Shield of California Commercial |
$5.77
|
| Rate for Payer: Blue Shield of California EPN |
$4.49
|
| Rate for Payer: Cash Price |
$4.13
|
| Rate for Payer: Central Health Plan Commercial |
$7.34
|
| Rate for Payer: Cigna of CA HMO |
$5.88
|
| Rate for Payer: Cigna of CA PPO |
$6.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.80
|
| Rate for Payer: Dignity Health Media |
$7.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.67
|
| Rate for Payer: Galaxy Health WC |
$7.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.84
|
| Rate for Payer: Multiplan Commercial |
$6.88
|
| Rate for Payer: Networks By Design Commercial |
$5.97
|
| Rate for Payer: Prime Health Services Commercial |
$7.80
|
| Rate for Payer: Riverside University Health System MISP |
$3.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.59
|
| Rate for Payer: United Healthcare All Other HMO |
$4.59
|
| Rate for Payer: United Healthcare HMO Rider |
$4.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7.80
|
|
|
HC TUBE ENDOTRACH 4.5MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
| Hospital Charge Code |
901607705
|
|
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 4.5MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
| Hospital Charge Code |
901607705
|
|
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 5.0MM NO CUFF
|
Facility
|
OP
|
$11.23
|
|
| Hospital Charge Code |
901604277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$10.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.63
|
| Rate for Payer: Blue Distinction Transplant |
$6.74
|
| Rate for Payer: Blue Shield of California Commercial |
$7.06
|
| Rate for Payer: Blue Shield of California EPN |
$5.49
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Central Health Plan Commercial |
$8.98
|
| Rate for Payer: Cigna of CA HMO |
$7.19
|
| Rate for Payer: Cigna of CA PPO |
$8.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.55
|
| Rate for Payer: Dignity Health Media |
$9.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.49
|
| Rate for Payer: Galaxy Health WC |
$9.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.25
|
| Rate for Payer: Multiplan Commercial |
$8.42
|
| Rate for Payer: Networks By Design Commercial |
$7.30
|
| Rate for Payer: Prime Health Services Commercial |
$9.55
|
| Rate for Payer: Riverside University Health System MISP |
$4.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.62
|
| Rate for Payer: United Healthcare All Other HMO |
$5.62
|
| Rate for Payer: United Healthcare HMO Rider |
$5.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.55
|
| Rate for Payer: Vantage Medical Group Senior |
$9.55
|
|
|
HC TUBE ENDOTRACH 5.0MM NO CUFF
|
Facility
|
IP
|
$11.23
|
|
| Hospital Charge Code |
901604277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$10.11 |
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Central Health Plan Commercial |
$8.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.49
|
| Rate for Payer: Galaxy Health WC |
$9.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.25
|
| Rate for Payer: Multiplan Commercial |
$8.42
|
| Rate for Payer: Networks By Design Commercial |
$7.30
|
| Rate for Payer: Prime Health Services Commercial |
$9.55
|
|
|
HC TUBE ENDOTRACH 5.0MM W/CUFF
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901604916
|
|
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 5.0MM W/CUFF
|
Facility
|
IP
|
$22.63
|
|
| Hospital Charge Code |
901604916
|
|
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 5.5MM UNCUFF
|
Facility
|
OP
|
$8.94
|
|
| Hospital Charge Code |
901698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: Blue Distinction Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: Dignity Health Media |
$7.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Riverside University Health System MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
IP
|
$14.84
|
|
| Hospital Charge Code |
901607706
|
|
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 5.5MM UNCUFF
|
Facility
|
IP
|
$8.94
|
|
| Hospital Charge Code |
901698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC TUBE ENDOTRACH 5.5MM UNCUFF
|
Facility
|
OP
|
$14.84
|
|
| Hospital Charge Code |
901607706
|
|
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 5.5MM W/CUFF
|
Facility
|
OP
|
$31.16
|
|
| Hospital Charge Code |
901698781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.41
|
| Rate for Payer: Blue Distinction Transplant |
$18.70
|
| Rate for Payer: Blue Shield of California Commercial |
$19.60
|
| Rate for Payer: Blue Shield of California EPN |
$15.24
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: Cigna of CA HMO |
$19.94
|
| Rate for Payer: Cigna of CA PPO |
$23.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.49
|
| Rate for Payer: Dignity Health Media |
$26.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
| Rate for Payer: Riverside University Health System MISP |
$12.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.58
|
| Rate for Payer: United Healthcare All Other HMO |
$15.58
|
| Rate for Payer: United Healthcare HMO Rider |
$15.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$26.49
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
IP
|
$11.97
|
|
| Hospital Charge Code |
901698575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.77 |
| Rate for Payer: Cash Price |
$5.39
|
| Rate for Payer: Central Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.39
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
OP
|
$11.97
|
|
| Hospital Charge Code |
901698575
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.07
|
| Rate for Payer: Blue Distinction Transplant |
$7.18
|
| Rate for Payer: Blue Shield of California Commercial |
$7.53
|
| Rate for Payer: Blue Shield of California EPN |
$5.85
|
| Rate for Payer: Cash Price |
$5.39
|
| Rate for Payer: Central Health Plan Commercial |
$9.58
|
| Rate for Payer: Cigna of CA HMO |
$7.66
|
| Rate for Payer: Cigna of CA PPO |
$8.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.17
|
| Rate for Payer: Dignity Health Media |
$10.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.77
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.39
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.98
|
| Rate for Payer: United Healthcare All Other HMO |
$5.98
|
| Rate for Payer: United Healthcare HMO Rider |
$5.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.17
|
| Rate for Payer: Vantage Medical Group Senior |
$10.17
|
|
|
HC TUBE ENDOTRACH 5.5MM W/CUFF
|
Facility
|
IP
|
$31.16
|
|
| Hospital Charge Code |
901698781
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
|
|
HC TUBE ENDOTRACH 5.5 W/CUFF
|
Facility
|
IP
|
$22.63
|
|
| Hospital Charge Code |
901602990
|
|
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 5.5 W/CUFF
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901602990
|
|
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 6.0MM UNCUFF
|
Facility
|
OP
|
$14.02
|
|
| Hospital Charge Code |
901607707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.28
|
| Rate for Payer: Blue Distinction Transplant |
$8.41
|
| Rate for Payer: Blue Shield of California Commercial |
$8.82
|
| Rate for Payer: Blue Shield of California EPN |
$6.86
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Central Health Plan Commercial |
$11.22
|
| Rate for Payer: Cigna of CA HMO |
$8.97
|
| Rate for Payer: Cigna of CA PPO |
$10.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.92
|
| Rate for Payer: Dignity Health Media |
$11.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.61
|
| Rate for Payer: Galaxy Health WC |
$11.92
|
| Rate for Payer: Global Benefits Group Commercial |
$8.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.62
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.52
|
| Rate for Payer: Networks By Design Commercial |
$9.11
|
| Rate for Payer: Prime Health Services Commercial |
$11.92
|
| Rate for Payer: Riverside University Health System MISP |
$5.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.92
|
| Rate for Payer: Vantage Medical Group Senior |
$11.92
|
|
|
HC TUBE ENDOTRACH 6.0MM UNCUFF
|
Facility
|
IP
|
$14.02
|
|
| Hospital Charge Code |
901607707
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.62 |
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Central Health Plan Commercial |
$11.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.61
|
| Rate for Payer: Galaxy Health WC |
$11.92
|
| Rate for Payer: Global Benefits Group Commercial |
$8.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.52
|
| Rate for Payer: Networks By Design Commercial |
$9.11
|
| Rate for Payer: Prime Health Services Commercial |
$11.92
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
OP
|
$43.95
|
|
| Hospital Charge Code |
901698722
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.97
|
| Rate for Payer: Blue Distinction Transplant |
$26.37
|
| Rate for Payer: Blue Shield of California Commercial |
$27.64
|
| Rate for Payer: Blue Shield of California EPN |
$21.49
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Central Health Plan Commercial |
$35.16
|
| Rate for Payer: Cigna of CA HMO |
$28.13
|
| Rate for Payer: Cigna of CA PPO |
$32.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.36
|
| Rate for Payer: Dignity Health Media |
$37.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.58
|
| Rate for Payer: Galaxy Health WC |
$37.36
|
| Rate for Payer: Global Benefits Group Commercial |
$26.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$32.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.79
|
| Rate for Payer: Multiplan Commercial |
$32.96
|
| Rate for Payer: Networks By Design Commercial |
$28.57
|
| Rate for Payer: Prime Health Services Commercial |
$37.36
|
| Rate for Payer: Riverside University Health System MISP |
$17.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.98
|
| Rate for Payer: United Healthcare All Other HMO |
$21.98
|
| Rate for Payer: United Healthcare HMO Rider |
$21.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.36
|
| Rate for Payer: Vantage Medical Group Senior |
$37.36
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901604279
|
|
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 6.0MM W/CUFF
|
Facility
|
OP
|
$15.58
|
|
| Hospital Charge Code |
901698797
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.20
|
| Rate for Payer: Blue Distinction Transplant |
$9.35
|
| Rate for Payer: Blue Shield of California Commercial |
$9.80
|
| Rate for Payer: Blue Shield of California EPN |
$7.62
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Central Health Plan Commercial |
$12.46
|
| Rate for Payer: Cigna of CA HMO |
$9.97
|
| Rate for Payer: Cigna of CA PPO |
$11.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.24
|
| Rate for Payer: Dignity Health Media |
$13.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.23
|
| Rate for Payer: Galaxy Health WC |
$13.24
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.02
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.12
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: Networks By Design Commercial |
$10.13
|
| Rate for Payer: Prime Health Services Commercial |
$13.24
|
| Rate for Payer: Riverside University Health System MISP |
$6.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.79
|
| Rate for Payer: United Healthcare All Other HMO |
$7.79
|
| Rate for Payer: United Healthcare HMO Rider |
$7.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.24
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
