|
HC TUBE SALEM SUMP ARGLYE 6FR PVC
|
Facility
OP
|
$41.25
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901607771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$45.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.37
|
| Rate for Payer: BCBS Transplant Transplant |
$24.75
|
| Rate for Payer: Blue Shield of California Commercial |
$25.95
|
| Rate for Payer: Blue Shield of California EPN |
$20.17
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: Cigna of CA HMO |
$26.40
|
| Rate for Payer: Cigna of CA PPO |
$30.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.94
|
| Rate for Payer: IEHP medi-cal |
$14.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: Riverside University Health MISP |
$16.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.06
|
| Rate for Payer: Vantage Medical Group Senior |
$35.06
|
|
|
HC TUBE SALEM SUMP ARGLYE 6FR PVC
|
Facility
IP
|
$41.25
|
|
|
Service Code
|
CPT B4082
|
| Hospital Charge Code |
901607771
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
|
|
HC TUBE SUMP 12FR NASOGASTRIC
|
Facility
OP
|
$12.30
|
|
| Hospital Charge Code |
901698300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.27
|
| Rate for Payer: BCBS Transplant Transplant |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$7.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.01
|
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: Cigna of CA HMO |
$7.87
|
| Rate for Payer: Cigna of CA PPO |
$9.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.22
|
| Rate for Payer: IEHP medi-cal |
$4.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.38
|
| Rate for Payer: Riverside University Health MISP |
$4.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.15
|
| Rate for Payer: United Healthcare All Other HMO |
$6.15
|
| Rate for Payer: United Healthcare HMO Rider |
$6.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.46
|
| Rate for Payer: Vantage Medical Group Senior |
$10.46
|
|
|
HC TUBE SUMP 12FR NASOGASTRIC
|
Facility
IP
|
$12.30
|
|
| Hospital Charge Code |
901698300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
|
|
HC TUBE THORACOSTOMY
|
Facility
OP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,317.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,429.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,889.01
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: Cigna of CA HMO |
$2,472.32
|
| Rate for Payer: Cigna of CA PPO |
$2,858.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,897.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,317.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,931.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,931.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,931.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,931.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC TUBE THORACOSTOMY
|
Facility
IP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$3,476.70 |
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,545.20
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
|
|
HC TUBE THORACOSTOMY
|
Facility
IP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$3,476.70 |
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,545.20
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
|
|
HC TUBE THORACOSTOMY
|
Facility
OP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$287.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,317.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: Cigna of CA HMO |
$2,472.32
|
| Rate for Payer: Cigna of CA PPO |
$2,858.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,897.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,317.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC TUBE THORACOSTOMY
|
Facility
IP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$3,476.70 |
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,545.20
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
|
|
HC TUBE THORACOSTOMY
|
Facility
OP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,317.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: Cigna of CA PPO |
$2,858.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,897.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,317.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC TUBE THORACOSTOMY
|
Facility
OP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,317.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: Cigna of CA PPO |
$2,858.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,897.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,317.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,931.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,931.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,931.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,931.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC TUBE THORACOSTOMY
|
Facility
IP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
900800116
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$3,476.70 |
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,545.20
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
|
|
HC TUBE THORACOSTOMY
|
Facility
IP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
988132551
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$3,476.70 |
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,545.20
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
|
|
HC TUBE THORACOSTOMY
|
Facility
OP
|
$3,863.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
988132551
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$772.60 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,317.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,429.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,889.01
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Cash Price |
$1,738.35
|
| Rate for Payer: Central Health Plan Commercial |
$3,090.40
|
| Rate for Payer: Cigna of CA HMO |
$2,472.32
|
| Rate for Payer: Cigna of CA PPO |
$2,858.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,283.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,317.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,476.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,897.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: IEHP medi-cal |
$3,301.67
|
| Rate for Payer: IEHP Medicare Advantage |
$2,001.01
|
| Rate for Payer: Innovage PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,576.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,897.25
|
| Rate for Payer: Networks By Design Commercial |
$2,510.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,283.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: Riverside University Health MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,317.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,317.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,931.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,931.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,931.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,931.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC TUBE TRACH 3.0 NEO 4.8MM
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901698353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH 3.0 NEO 4.8MM
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901698353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH 6.0MM HI-LO CUFFED
|
Facility
OP
|
$11.97
|
|
| Hospital Charge Code |
901698442
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$10.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.58
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$8.98
|
| Rate for Payer: IEHP medi-cal |
$4.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$7.18
|
| Rate for Payer: Riverside University Health 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 TRACH 6.0MM HI-LO CUFFED
|
Facility
IP
|
$11.97
|
|
| Hospital Charge Code |
901698442
|
|
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: 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 TRACH AD SHILEY CUFF 10
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901698518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TUBE TRACH AD SHILEY CUFF 10
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901698518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TUBE TRACH AD SHILEY CUFF 6.5
|
Facility
IP
|
$350.38
|
|
| Hospital Charge Code |
901698515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$315.34 |
| Rate for Payer: Cash Price |
$157.67
|
| Rate for Payer: Central Health Plan Commercial |
$280.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.15
|
| Rate for Payer: Galaxy Health WC |
$297.82
|
| Rate for Payer: Global Benefits Group Commercial |
$210.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.08
|
| Rate for Payer: Multiplan Commercial |
$262.78
|
| Rate for Payer: Networks By Design Commercial |
$227.75
|
| Rate for Payer: Prime Health Services Commercial |
$297.82
|
|
|
HC TUBE TRACH AD SHILEY CUFF 6.5
|
Facility
OP
|
$350.38
|
|
| Hospital Charge Code |
901698515
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$315.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$212.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.00
|
| Rate for Payer: BCBS Transplant Transplant |
$210.23
|
| Rate for Payer: Blue Shield of California Commercial |
$220.39
|
| Rate for Payer: Blue Shield of California EPN |
$171.34
|
| Rate for Payer: Cash Price |
$157.67
|
| Rate for Payer: Central Health Plan Commercial |
$280.30
|
| Rate for Payer: Cigna of CA HMO |
$224.24
|
| Rate for Payer: Cigna of CA PPO |
$259.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.15
|
| Rate for Payer: Galaxy Health WC |
$297.82
|
| Rate for Payer: Global Benefits Group Commercial |
$210.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.78
|
| Rate for Payer: IEHP medi-cal |
$122.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.08
|
| Rate for Payer: Multiplan Commercial |
$262.78
|
| Rate for Payer: Networks By Design Commercial |
$227.75
|
| Rate for Payer: Prime Health Services Commercial |
$297.82
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.23
|
| Rate for Payer: Riverside University Health MISP |
$140.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.19
|
| Rate for Payer: United Healthcare All Other HMO |
$175.19
|
| Rate for Payer: United Healthcare HMO Rider |
$175.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.82
|
| Rate for Payer: Vantage Medical Group Senior |
$297.82
|
|
|
HC TUBE TRACH AD SHILEY CUFF 7.5
|
Facility
IP
|
$350.38
|
|
| Hospital Charge Code |
901698516
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$315.34 |
| Rate for Payer: Cash Price |
$157.67
|
| Rate for Payer: Central Health Plan Commercial |
$280.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.15
|
| Rate for Payer: Galaxy Health WC |
$297.82
|
| Rate for Payer: Global Benefits Group Commercial |
$210.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.08
|
| Rate for Payer: Multiplan Commercial |
$262.78
|
| Rate for Payer: Networks By Design Commercial |
$227.75
|
| Rate for Payer: Prime Health Services Commercial |
$297.82
|
|
|
HC TUBE TRACH AD SHILEY CUFF 7.5
|
Facility
OP
|
$350.38
|
|
| Hospital Charge Code |
901698516
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$315.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$212.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.00
|
| Rate for Payer: BCBS Transplant Transplant |
$210.23
|
| Rate for Payer: Blue Shield of California Commercial |
$220.39
|
| Rate for Payer: Blue Shield of California EPN |
$171.34
|
| Rate for Payer: Cash Price |
$157.67
|
| Rate for Payer: Central Health Plan Commercial |
$280.30
|
| Rate for Payer: Cigna of CA HMO |
$224.24
|
| Rate for Payer: Cigna of CA PPO |
$259.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.15
|
| Rate for Payer: Galaxy Health WC |
$297.82
|
| Rate for Payer: Global Benefits Group Commercial |
$210.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.78
|
| Rate for Payer: IEHP medi-cal |
$122.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.08
|
| Rate for Payer: Multiplan Commercial |
$262.78
|
| Rate for Payer: Networks By Design Commercial |
$227.75
|
| Rate for Payer: Prime Health Services Commercial |
$297.82
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.23
|
| Rate for Payer: Riverside University Health MISP |
$140.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.19
|
| Rate for Payer: United Healthcare All Other HMO |
$175.19
|
| Rate for Payer: United Healthcare HMO Rider |
$175.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.82
|
| Rate for Payer: Vantage Medical Group Senior |
$297.82
|
|
|
HC TUBE TRACH AD SHILEY CUFF 8.5
|
Facility
OP
|
$470.15
|
|
| Hospital Charge Code |
901698517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.03 |
| Max. Negotiated Rate |
$423.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$285.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$399.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$258.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$258.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$277.76
|
| Rate for Payer: BCBS Transplant Transplant |
$282.09
|
| Rate for Payer: Blue Shield of California Commercial |
$295.72
|
| Rate for Payer: Blue Shield of California EPN |
$229.90
|
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Central Health Plan Commercial |
$376.12
|
| Rate for Payer: Cigna of CA HMO |
$300.90
|
| Rate for Payer: Cigna of CA PPO |
$347.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$399.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$188.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$188.06
|
| Rate for Payer: Galaxy Health WC |
$399.63
|
| Rate for Payer: Global Benefits Group Commercial |
$282.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$423.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$352.61
|
| Rate for Payer: IEHP medi-cal |
$164.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$313.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.03
|
| Rate for Payer: Multiplan Commercial |
$352.61
|
| Rate for Payer: Networks By Design Commercial |
$305.60
|
| Rate for Payer: Prime Health Services Commercial |
$399.63
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$282.09
|
| Rate for Payer: Riverside University Health MISP |
$188.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$282.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$282.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$235.08
|
| Rate for Payer: United Healthcare All Other HMO |
$235.08
|
| Rate for Payer: United Healthcare HMO Rider |
$235.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$235.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$399.63
|
| Rate for Payer: Vantage Medical Group Senior |
$399.63
|
|
