|
HC TUBE TRACH AD SHILEY CUFF 8.5
|
Facility
IP
|
$470.15
|
|
| Hospital Charge Code |
901698517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.03 |
| Max. Negotiated Rate |
$423.14 |
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Central Health Plan Commercial |
$376.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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
|
|
|
HC TUBE TRACH BIVONA 3.5 PEDS
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901604123
|
|
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 BIVONA 3.5 PEDS
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901604123
|
|
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 BIVONA 4.0 PEDS
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901604124
|
|
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 BIVONA 4.0 PEDS
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901604124
|
|
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 BIVONA 4.5 PEDS
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901605006
|
|
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 BIVONA 4.5 PEDS
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901605006
|
|
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 BIVONA 5.0 PEDS
|
Facility
OP
|
$634.80
|
|
| Hospital Charge Code |
901604126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$385.51
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$349.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$307.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$375.04
|
| Rate for Payer: BCBS Transplant Transplant |
$380.88
|
| Rate for Payer: Blue Shield of California Commercial |
$399.29
|
| Rate for Payer: Blue Shield of California EPN |
$310.42
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$476.10
|
| Rate for Payer: IEHP medi-cal |
$222.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: Riverside University Health MISP |
$253.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC TUBE TRACH BIVONA 5.0 PEDS
|
Facility
IP
|
$634.80
|
|
| Hospital Charge Code |
901604126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$571.32 |
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Central Health Plan Commercial |
$507.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.96
|
| Rate for Payer: Multiplan Commercial |
$476.10
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC TUBE TRACH BIVONA 5.5 PEDS
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
901604127
|
|
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 BIVONA 5.5 PEDS
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
901604127
|
|
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 BIVONA 6.0 ADJUST
|
Facility
IP
|
$843.36
|
|
| Hospital Charge Code |
901604136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.67 |
| Max. Negotiated Rate |
$759.02 |
| Rate for Payer: Cash Price |
$379.51
|
| Rate for Payer: Central Health Plan Commercial |
$674.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.34
|
| Rate for Payer: Galaxy Health WC |
$716.86
|
| Rate for Payer: Global Benefits Group Commercial |
$506.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$562.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.67
|
| Rate for Payer: Multiplan Commercial |
$632.52
|
| Rate for Payer: Networks By Design Commercial |
$548.18
|
| Rate for Payer: Prime Health Services Commercial |
$716.86
|
|
|
HC TUBE TRACH BIVONA 6.0 ADJUST
|
Facility
OP
|
$843.36
|
|
| Hospital Charge Code |
901604136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$168.67 |
| Max. Negotiated Rate |
$759.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$512.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$716.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$463.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$463.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$498.26
|
| Rate for Payer: BCBS Transplant Transplant |
$506.02
|
| Rate for Payer: Blue Shield of California Commercial |
$530.47
|
| Rate for Payer: Blue Shield of California EPN |
$412.40
|
| Rate for Payer: Cash Price |
$379.51
|
| Rate for Payer: Central Health Plan Commercial |
$674.69
|
| Rate for Payer: Cigna of CA HMO |
$539.75
|
| Rate for Payer: Cigna of CA PPO |
$624.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$716.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$337.34
|
| Rate for Payer: Galaxy Health WC |
$716.86
|
| Rate for Payer: Global Benefits Group Commercial |
$506.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$759.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$632.52
|
| Rate for Payer: IEHP medi-cal |
$295.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$562.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.67
|
| Rate for Payer: Multiplan Commercial |
$632.52
|
| Rate for Payer: Networks By Design Commercial |
$548.18
|
| Rate for Payer: Prime Health Services Commercial |
$716.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$506.02
|
| Rate for Payer: Riverside University Health MISP |
$337.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$506.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$506.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.68
|
| Rate for Payer: United Healthcare All Other HMO |
$421.68
|
| Rate for Payer: United Healthcare HMO Rider |
$421.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$421.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$716.86
|
| Rate for Payer: Vantage Medical Group Senior |
$716.86
|
|
|
HC TUBE TRACH BIVONA7.0 ADULT ECR
|
Facility
IP
|
$572.63
|
|
| Hospital Charge Code |
901692006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$515.37 |
| Rate for Payer: Cash Price |
$257.68
|
| Rate for Payer: Central Health Plan Commercial |
$458.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$229.05
|
| Rate for Payer: Galaxy Health WC |
$486.74
|
| Rate for Payer: Global Benefits Group Commercial |
$343.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$515.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$381.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.53
|
| Rate for Payer: Multiplan Commercial |
$429.47
|
| Rate for Payer: Networks By Design Commercial |
$372.21
|
| Rate for Payer: Prime Health Services Commercial |
$486.74
|
|
|
HC TUBE TRACH BIVONA7.0 ADULT ECR
|
Facility
OP
|
$572.63
|
|
| Hospital Charge Code |
901692006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$515.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$347.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$486.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$314.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$314.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$277.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$338.31
|
| Rate for Payer: BCBS Transplant Transplant |
$343.58
|
| Rate for Payer: Blue Shield of California Commercial |
$360.18
|
| Rate for Payer: Blue Shield of California EPN |
$280.02
|
| Rate for Payer: Cash Price |
$257.68
|
| Rate for Payer: Central Health Plan Commercial |
$458.10
|
| Rate for Payer: Cigna of CA HMO |
$366.48
|
| Rate for Payer: Cigna of CA PPO |
$423.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$486.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$229.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.05
|
| Rate for Payer: Galaxy Health WC |
$486.74
|
| Rate for Payer: Global Benefits Group Commercial |
$343.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$515.37
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$429.47
|
| Rate for Payer: IEHP medi-cal |
$200.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$381.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$114.53
|
| Rate for Payer: Multiplan Commercial |
$429.47
|
| Rate for Payer: Networks By Design Commercial |
$372.21
|
| Rate for Payer: Prime Health Services Commercial |
$486.74
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$343.58
|
| Rate for Payer: Riverside University Health MISP |
$229.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$343.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$343.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$286.32
|
| Rate for Payer: United Healthcare All Other HMO |
$286.32
|
| Rate for Payer: United Healthcare HMO Rider |
$286.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$286.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$486.74
|
| Rate for Payer: Vantage Medical Group Senior |
$486.74
|
|
|
HC TUBE TRACH BIVONA FLEXTEND NEO
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
900800711
|
|
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 BIVONA FLEXTEND NEO
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
900800711
|
|
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 BIVONA FLEXTEND PED
|
Facility
IP
|
$350.00
|
|
| Hospital Charge Code |
900800710
|
|
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 BIVONA FLEXTEND PED
|
Facility
OP
|
$350.00
|
|
| Hospital Charge Code |
900800710
|
|
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 DBL SWIVEL ELB 12FR
|
Facility
IP
|
$76.10
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$68.49 |
| Rate for Payer: Cash Price |
$34.25
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.68
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.46
|
| Rate for Payer: Prime Health Services Commercial |
$64.68
|
|
|
HC TUBE TRACH DBL SWIVEL ELB 12FR
|
Facility
OP
|
$76.10
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$68.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$64.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$41.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$41.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.96
|
| Rate for Payer: BCBS Transplant Transplant |
$45.66
|
| Rate for Payer: Blue Shield of California Commercial |
$47.87
|
| Rate for Payer: Blue Shield of California EPN |
$37.21
|
| Rate for Payer: Cash Price |
$34.25
|
| Rate for Payer: Cash Price |
$34.25
|
| Rate for Payer: Central Health Plan Commercial |
$60.88
|
| Rate for Payer: Cigna of CA HMO |
$48.70
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$64.68
|
| Rate for Payer: Global Benefits Group Commercial |
$45.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$57.08
|
| Rate for Payer: IEHP medi-cal |
$26.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.22
|
| Rate for Payer: Multiplan Commercial |
$57.08
|
| Rate for Payer: Networks By Design Commercial |
$49.46
|
| Rate for Payer: Prime Health Services Commercial |
$64.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$45.66
|
| Rate for Payer: Riverside University Health MISP |
$30.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.05
|
| Rate for Payer: United Healthcare All Other HMO |
$38.05
|
| Rate for Payer: United Healthcare HMO Rider |
$38.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.68
|
| Rate for Payer: Vantage Medical Group Senior |
$64.68
|
|
|
HC TUBE TRACH NASAL 2.5MM W/CUFF
|
Facility
IP
|
$31.16
|
|
| Hospital Charge Code |
901698782
|
|
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 TRACH NASAL 2.5MM W/CUFF
|
Facility
OP
|
$31.16
|
|
| Hospital Charge Code |
901698782
|
|
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 TRACH NASAL 3.5MM W/CUFF
|
Facility
OP
|
$31.16
|
|
| Hospital Charge Code |
901698783
|
|
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 TRACH NASAL 3.5MM W/CUFF
|
Facility
IP
|
$31.16
|
|
| Hospital Charge Code |
901698783
|
|
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
|
|
