|
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: AlphaCare Medical Group Commercial/Exchange |
$13.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$11.68
|
| Rate for Payer: IEHP medi-cal |
$5.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.39
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: Riverside University Health 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
|
|
|
HC TUBE ENDOTRACH 6.0MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604279
|
|
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: 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 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: AlphaCare Medical Group Commercial/Exchange |
$37.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.17
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$32.96
|
| Rate for Payer: IEHP medi-cal |
$15.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.31
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$26.37
|
| Rate for Payer: Riverside University Health 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 6.5MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604280
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 6.5MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604280
|
|
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: 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 6.5MM W/CUFF
|
Facility
OP
|
$31.16
|
|
| Hospital Charge Code |
901698788
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.14
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$23.37
|
| Rate for Payer: IEHP medi-cal |
$10.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.78
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$18.70
|
| Rate for Payer: Riverside University Health 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 6.5MM W/CUFF
|
Facility
IP
|
$31.16
|
|
| Hospital Charge Code |
901698788
|
|
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: 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 7.0MM W/CUFF
|
Facility
OP
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$36.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.08
|
| Rate for Payer: BCBS Transplant Transplant |
$24.45
|
| Rate for Payer: Blue Shield of California Commercial |
$25.63
|
| Rate for Payer: Blue Shield of California EPN |
$19.93
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Central Health Plan Commercial |
$32.60
|
| Rate for Payer: Cigna of CA HMO |
$26.08
|
| Rate for Payer: Cigna of CA PPO |
$30.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$34.64
|
| Rate for Payer: Global Benefits Group Commercial |
$24.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.56
|
| Rate for Payer: IEHP medi-cal |
$14.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$30.56
|
| Rate for Payer: Networks By Design Commercial |
$26.49
|
| Rate for Payer: Prime Health Services Commercial |
$34.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.45
|
| Rate for Payer: Riverside University Health MISP |
$16.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.38
|
| Rate for Payer: United Healthcare All Other HMO |
$20.38
|
| Rate for Payer: United Healthcare HMO Rider |
$20.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.64
|
| Rate for Payer: Vantage Medical Group Senior |
$34.64
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
IP
|
$40.75
|
|
| Hospital Charge Code |
901698771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$36.68 |
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Central Health Plan Commercial |
$32.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$34.64
|
| Rate for Payer: Global Benefits Group Commercial |
$24.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$30.56
|
| Rate for Payer: Networks By Design Commercial |
$26.49
|
| Rate for Payer: Prime Health Services Commercial |
$34.64
|
|
|
HC TUBE ENDOTRACH 7.0MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604281
|
|
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: 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 7.0MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604281
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 7.5MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604282
|
|
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: 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 7.5MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604282
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 8.0MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604283
|
|
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: 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 8.0MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604283
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 8.5MM W/CUFF
|
Facility
IP
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Central Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.23
|
| Rate for Payer: Galaxy Health WC |
$13.24
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.39
|
| 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
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
OP
|
$15.58
|
|
| Hospital Charge Code |
901698773
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$11.68
|
| Rate for Payer: IEHP medi-cal |
$5.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.39
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: Riverside University Health 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
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
IP
|
$93.40
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$84.06 |
| Rate for Payer: Cash Price |
$42.03
|
| Rate for Payer: Central Health Plan Commercial |
$74.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.36
|
| Rate for Payer: Galaxy Health WC |
$79.39
|
| Rate for Payer: Global Benefits Group Commercial |
$56.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.68
|
| Rate for Payer: Multiplan Commercial |
$70.05
|
| Rate for Payer: Networks By Design Commercial |
$60.71
|
| Rate for Payer: Prime Health Services Commercial |
$79.39
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
OP
|
$93.40
|
|
| Hospital Charge Code |
901698712
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$84.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$79.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$51.37
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.18
|
| Rate for Payer: BCBS Transplant Transplant |
$56.04
|
| Rate for Payer: Blue Shield of California Commercial |
$58.75
|
| Rate for Payer: Blue Shield of California EPN |
$45.67
|
| Rate for Payer: Cash Price |
$42.03
|
| Rate for Payer: Central Health Plan Commercial |
$74.72
|
| Rate for Payer: Cigna of CA HMO |
$59.78
|
| Rate for Payer: Cigna of CA PPO |
$69.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.36
|
| Rate for Payer: Galaxy Health WC |
$79.39
|
| Rate for Payer: Global Benefits Group Commercial |
$56.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.06
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$70.05
|
| Rate for Payer: IEHP medi-cal |
$32.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.68
|
| Rate for Payer: Multiplan Commercial |
$70.05
|
| Rate for Payer: Networks By Design Commercial |
$60.71
|
| Rate for Payer: Prime Health Services Commercial |
$79.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$56.04
|
| Rate for Payer: Riverside University Health MISP |
$37.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.70
|
| Rate for Payer: United Healthcare All Other HMO |
$46.70
|
| Rate for Payer: United Healthcare HMO Rider |
$46.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$79.39
|
| Rate for Payer: Vantage Medical Group Senior |
$79.39
|
|
|
HC TUBE ENDOTRACH 8.5MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604284
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 8.5MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604284
|
|
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: 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 9.0MM W/CUFF
|
Facility
OP
|
$22.63
|
|
| Hospital Charge Code |
901604285
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$16.97
|
| Rate for Payer: IEHP medi-cal |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: Riverside University Health 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 9.0MM W/CUFF
|
Facility
IP
|
$22.63
|
|
| Hospital Charge Code |
901604285
|
|
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: 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 9MM W/CUFF
|
Facility
IP
|
$37.72
|
|
| Hospital Charge Code |
901698710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$33.95 |
| Rate for Payer: Cash Price |
$16.97
|
| Rate for Payer: Central Health Plan Commercial |
$30.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.09
|
| Rate for Payer: Galaxy Health WC |
$32.06
|
| Rate for Payer: Global Benefits Group Commercial |
$22.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.54
|
| Rate for Payer: Multiplan Commercial |
$28.29
|
| Rate for Payer: Networks By Design Commercial |
$24.52
|
| Rate for Payer: Prime Health Services Commercial |
$32.06
|
|
|
HC TUBE ENDOTRACH 9MM W/CUFF
|
Facility
OP
|
$37.72
|
|
| Hospital Charge Code |
901698710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$33.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.28
|
| Rate for Payer: BCBS Transplant Transplant |
$22.63
|
| Rate for Payer: Blue Shield of California Commercial |
$23.73
|
| Rate for Payer: Blue Shield of California EPN |
$18.45
|
| Rate for Payer: Cash Price |
$16.97
|
| Rate for Payer: Central Health Plan Commercial |
$30.18
|
| Rate for Payer: Cigna of CA HMO |
$24.14
|
| Rate for Payer: Cigna of CA PPO |
$27.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.09
|
| Rate for Payer: Galaxy Health WC |
$32.06
|
| Rate for Payer: Global Benefits Group Commercial |
$22.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.95
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.29
|
| Rate for Payer: IEHP medi-cal |
$13.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.54
|
| Rate for Payer: Multiplan Commercial |
$28.29
|
| Rate for Payer: Networks By Design Commercial |
$24.52
|
| Rate for Payer: Prime Health Services Commercial |
$32.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.63
|
| Rate for Payer: Riverside University Health MISP |
$15.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.86
|
| Rate for Payer: United Healthcare All Other HMO |
$18.86
|
| Rate for Payer: United Healthcare HMO Rider |
$18.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.06
|
| Rate for Payer: Vantage Medical Group Senior |
$32.06
|
|
